Provider Demographics
NPI:1467045971
Name:PROFESSIONAL INTEGRATED HEALTHCARE (PIHC), PLLC
Entity Type:Organization
Organization Name:PROFESSIONAL INTEGRATED HEALTHCARE (PIHC), PLLC
Other - Org Name:PROFESSIONAL INTEGRATED HEALTHCARE (PIHC), PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:865-219-1989
Mailing Address - Street 1:9221 MIDDLEBROOK PIKE STE 102
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-4764
Mailing Address - Country:US
Mailing Address - Phone:865-219-1989
Mailing Address - Fax:865-409-5974
Practice Address - Street 1:9221 MIDDLEBROOK PIKE STE 102
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-4764
Practice Address - Country:US
Practice Address - Phone:865-219-1989
Practice Address - Fax:865-409-5974
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROFESSIONAL INTEGRATED HEALTHCARE (PIHC), PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-16
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ045837Medicaid