Provider Demographics
NPI:1164993689
Name:TLC FAMILY HEALTH & HORMONE PLLC
Entity Type:Organization
Organization Name:TLC FAMILY HEALTH & HORMONE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:931-563-7464
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-0326
Mailing Address - Country:US
Mailing Address - Phone:931-563-7464
Mailing Address - Fax:931-563-7401
Practice Address - Street 1:215 S ANDERSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3735
Practice Address - Country:US
Practice Address - Phone:931-563-7464
Practice Address - Fax:931-563-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty