Benita K Qualls in Lebanon - Physician Assistant
Benita K Qualls - NPI 1629245634
Benita K Qualls is a Physician Assistant in Lebanon, Tennessee. Benita K Qualls practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Benita K Qualls is 1629245634. The last update date is 2011-08-09.
Benita K Qualls's current location address is 1407 W Baddour Pkwy, Lebanon, Tennessee. You can contact this provider via phone number 6154446203 and fax number 6154446252. The mailing address for Benita K Qualls is 1407 W Baddour Pkwy, Lebanon, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Benita K Qualls |
|---|---|
| Address | 1407 W Baddour Pkwy, Lebanon, Tennessee |
| Phone Number | 6154446203 |
| Fax Number | 6154446252 |
| Sole Proprietor | N |
| Credentials | P.A. |
NPI Number Detail
| NPI Number | 1629245634 |
|---|---|
| Provider Enumeration Date | 2008-05-09 |
| Last Updated Date | 2011-08-09 |
Provider Mailing Address Detail
| Address | 1407 W Baddour Pkwy |
|---|---|
| City | Lebanon |
| State | Tennessee (TN) |
| Post Code | 370872513 |
| Phone Number | 6154446203 |
| Fax Number | 6154446252 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 185 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3323092 | TN | UHC | |
| 1523861 | TN | -- | |
| 185 | TN | PHYSICIAN ASSISTANT LICENSE | |
| 4298144 | TN | BCBS |
Post Comment/ Review Below
What is the unique identifier code issued to Benita K Qualls by the Centers for Medicare & Medicaid Services?
The Benita K Qualls has been assigned the NPI (National Provider Identifier) 1629245634. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Benita K Qualls is located?
The Benita K Qualls is situated at the following address: 1407 W Baddour Pkwy, Lebanon, TN, 370872513.
What is Benita K Qualls's area of expertise and its corresponding taxonomy classification?
The Benita K Qualls's field of specialization is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their areas of practice.
On what date was the 1629245634 assigned to Benita K Qualls?
The Benita K Qualls was issued its 1629245634 on 2008-05-09, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Benita K Qualls, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Benita K Qualls, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2011-08-09.