Provider Demographics
NPI:1477870525
Name:STUMB HEALTHCARE PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:STUMB HEALTHCARE PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:STUMB
Authorized Official - Suffix:
Authorized Official - Credentials:DNP APRN BC
Authorized Official - Phone:615-489-7256
Mailing Address - Street 1:236 DIXON SPRINGS HW
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37030
Mailing Address - Country:US
Mailing Address - Phone:615-489-7256
Mailing Address - Fax:
Practice Address - Street 1:619 N. MAIN ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030
Practice Address - Country:US
Practice Address - Phone:615-489-7256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14465261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care