Provider Demographics
NPI:1376258145
Name:WOMACK, ANNA RUTH (PA-C)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:RUTH
Last Name:WOMACK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-2934
Mailing Address - Country:US
Mailing Address - Phone:931-743-0592
Mailing Address - Fax:
Practice Address - Street 1:203 S ARROWHEAD DR
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2934
Practice Address - Country:US
Practice Address - Phone:931-743-0592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant