Provider Demographics
NPI:1164104881
Name:ONE STOP FAMILY CLINIC LLC
Entity Type:Organization
Organization Name:ONE STOP FAMILY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:615-900-4045
Mailing Address - Street 1:5964 MANCHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-7811
Mailing Address - Country:US
Mailing Address - Phone:615-900-4045
Mailing Address - Fax:615-900-4059
Practice Address - Street 1:3307 MANCHESTER PIKE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-7718
Practice Address - Country:US
Practice Address - Phone:615-900-4045
Practice Address - Fax:615-900-4059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty