Provider Demographics
NPI:1144602574
Name:HARROGATE HEALTH GROUP LLC
Entity Type:Organization
Organization Name:HARROGATE HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:423-441-8011
Mailing Address - Street 1:PO BOX 44
Mailing Address - Street 2:
Mailing Address - City:HARROGATE
Mailing Address - State:TN
Mailing Address - Zip Code:37752-0044
Mailing Address - Country:US
Mailing Address - Phone:423-441-8011
Mailing Address - Fax:423-441-8014
Practice Address - Street 1:6650 CUMBERLAND GAP PKWY
Practice Address - Street 2:
Practice Address - City:HARROGATE
Practice Address - State:TN
Practice Address - Zip Code:37752-8012
Practice Address - Country:US
Practice Address - Phone:423-441-8011
Practice Address - Fax:423-441-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty