Longevity Clinical Ltc Associates Of Tennessee, PLLC
Family Medicine, Geriatric Medicine in Red Boiling Springs, TN. Organization (NPI-2).
NPI number1326878299
StatusActive
Last updated in NPPESAug 6, 2024
Details
- NPI
- 1326878299
- Entity type
- Organization (NPI-2)
- Legal business name
- Longevity Clinical Ltc Associates Of Tennessee, PLLC
- Organization subpart
- No
- Enumeration date
- Aug 6, 2024
- Certification date
- Aug 6, 2024
- Last updated
- Aug 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QG0300X | Family Medicine, Geriatric Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 363LG0600X | Nurse Practitioner, Gerontology | – | – | |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – |
Practice location
309 Main StRed Boiling Springs, TN 37150-2149
Phone 615-699-2238
Mailing address
11780 Us Highway 1 Ste N107North Palm Beach, FL 33408-3007
Phone 561-815-2427
Authorized official
Diane Vincur
Practice Manager
5618152427
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Family Medicine, Geriatric Medicine providers in Red Boiling Springs, TN
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.