Provider Demographics
NPI:1083360135
Name:NEIGHBORING NURSES ASSOCIATION
Entity Type:Organization
Organization Name:NEIGHBORING NURSES ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:423-506-5310
Mailing Address - Street 1:1025 VETERANS MEMORIAL HWY SE STE 660
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-7711
Mailing Address - Country:US
Mailing Address - Phone:912-557-9003
Mailing Address - Fax:912-205-2437
Practice Address - Street 1:111 COUNTY ROAD 258
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-6567
Practice Address - Country:US
Practice Address - Phone:423-506-5310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN77186204Medicaid