institution
East Tennessee State University
Primary Care Nurse Practitioner in Johnson City, Tennessee
NPI 1568570273

East Tennessee State University is a Primary Care Nurse Practitioner based in Johnson City, TN and is specialized in Primary Care. East Tennessee State University practices in Johnson City, TN. The NPI Number for East Tennessee State University is 1568570273 and holds a License No. (Tennessee).

The current practice location address for East Tennessee State University is 365 Stout Drive, Johnson City, TN and can be reached out via phone at 423-439-4225 and via fax at 423-439-4560.

Location: 365 Stout Drive, Johnson City, TN, 37614-1703
institution
Provider Profile Details
NPI Number
1568570273
Provider Name
East Tennessee State University
Credential
Provider Entity Type
Organization
Address
365 Stout Drive, Johnson City, TN, 37614-1703
Phone Number
423-439-4225
Fax Number
423-439-4560
Provider Enumeration Date
08/25/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3709292 05 TN
institution
Provider Business Practice Location Address Details
Address
365 Stout Drive
City
State
Zip
37614-6500
Phone Number
423-439-4225
Fax Number
423-439-4560
person
Provider Business Mailing Address Details
Address
365 Stout Drive
City
State
Zip
37614-6500
Phone Number
423-439-4225
Fax Number
423-439-4560
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
()
Definition
Definition to come...
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