Provider Demographics
NPI:1245805712
Name:ANEW FAMILY MEDICAL PLLC
Entity Type:Organization
Organization Name:ANEW FAMILY MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOORE-RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-837-5028
Mailing Address - Street 1:111 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-2313
Mailing Address - Country:US
Mailing Address - Phone:731-989-2829
Mailing Address - Fax:
Practice Address - Street 1:702 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:TN
Practice Address - Zip Code:38052-3615
Practice Address - Country:US
Practice Address - Phone:731-837-5028
Practice Address - Fax:731-837-5027
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANEW FAMILY MEDICAL, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-26
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty