La Wanna Wallen Brock in Cumberland Gap - Family
La Wanna Wallen Brock - NPI 1407932387
La Wanna Wallen Brock is a Family in Cumberland Gap, Tennessee. La Wanna Wallen Brock practices all healthcare services and medical treatments related to Family. The NPI Number for La Wanna Wallen Brock is 1407932387. The last update date is 2007-07-08.
La Wanna Wallen Brock's current location address is 1037 Old Jacksboro Rd, Cumberland Gap, Tennessee. You can contact this provider via phone number 4236266145 and fax number 4235262804. The mailing address for La Wanna Wallen Brock is 1037 Old Jacksboro Rd, Cumberland Gap, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | La Wanna Wallen Brock |
|---|---|
| Address | 1037 Old Jacksboro Rd, Cumberland Gap, Tennessee |
| Phone Number | 4236266145 |
| Fax Number | 4235262804 |
| Sole Proprietor | N |
| Credentials | F.N.P., A. |
NPI Number Detail
| NPI Number | 1407932387 |
|---|---|
| Provider Enumeration Date | 2006-10-31 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1037 Old Jacksboro Rd |
|---|---|
| City | Cumberland Gap |
| State | Tennessee (TN) |
| Post Code | 377244444 |
| Phone Number | 4236266145 |
| Fax Number | 4235262804 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | APN6601 |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Post Comment/ Review Below
What is the unique provider identifier assigned to La Wanna Wallen Brock?
The La Wanna Wallen Brock has been issued the NPI (National Provider Identifier) 1407932387 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical location address where La Wanna Wallen Brock's facilities are situated?
The facilities of La Wanna Wallen Brock are physically located at the following address: 1037 Old Jacksboro Rd, Cumberland Gap, TN, 377244444.
What is the La Wanna Wallen Brock's area of specialization and corresponding taxonomy classification?
The La Wanna Wallen Brock's specialty field is Family, and it falls under the taxonomy code 363Lf0000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1407932387 to La Wanna Wallen Brock?
The Centers for Medicare & Medicaid Services originally issued the 1407932387 to La Wanna Wallen Brock on 2006-10-31.
As of what date were the details pertaining to La Wanna Wallen Brock last refreshed?
The information related to the La Wanna Wallen Brock, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
NPI Number: 1063415297
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