Provider Demographics
NPI:1255686424
Name:NP ENTERPRISES INC
Entity Type:Organization
Organization Name:NP ENTERPRISES INC
Other - Org Name:FAMILY WALK-IN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:PERNELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:931-707-7113
Mailing Address - Street 1:42 DOOLEY ST
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-4055
Mailing Address - Country:US
Mailing Address - Phone:931-707-7117
Mailing Address - Fax:931-707-7113
Practice Address - Street 1:42 DOOLEY ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-4055
Practice Address - Country:US
Practice Address - Phone:931-707-7117
Practice Address - Fax:931-707-7113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN448909Medicare Oscar/Certification