East Tennessee State University

NPI 1093990608 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1093990608
Enumeration Date 01/02/2008
Last Updated 06/08/2016
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name DAVID D. DAVID
Position CFO, VP FINANCE & ADMINISTRATION
Phone (423) 434-0894
Fax (423) 926-5999
Practice Location
202 W FAIRVIEW AVE
JOHNSON CITY TN, 37604-5611, US
Phone (423) 434-0894
Fax (423) 926-5999
Business Location
365 STOUT DRIVE BOX 70403
JOHNSON CITY TN, 37614-1703, US
Phone (423) 439-4515
Fax (423) 439-4060
Toxanomy
Taxonomy Code 363LF0000X
License State
License Number
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According to our database, East Tennessee State University NPI is 1093990608, taxonomy code is 363LF0000X East Tennessee State University physically located at 202 W Fairview Ave, Johnson City TN, 37604-5611. NPI Number 1033115704 has the healthcare provider type.

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1093990608 NPI number is provided on an as is basis without warranty of any kind. 1093990608 is maintained by the National Plan & Provider Enumeration System. The contents of East Tennessee State University are for informational purposes only.