Organization · NPI-2

1 Team LLC Tazewell

Nurse Practitioner, Family · Tazewell, TN

NPI number1710425368
StatusActive
Last updated in NPPESFeb 3, 2017

Details

NPI
1710425368
Entity type
Organization (NPI-2)
Legal business name
1 Team LLC Tazewell
Organization subpart
No
Enumeration date
Feb 3, 2017
Last updated
Feb 3, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family1366442782TNYes

Practice location

150 Hester Ln
Tazewell, TN 37879-5088

Phone 423-851-1149

Mailing address

Po Box 416
Greeneville, TN 37744-0416

Phone 423-639-0187

Authorized official

Charles C. Doty
President
4236390187

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