Provider Demographics
NPI:1598167942
Name:WINCHESTER CHRISTIAN HEALTHCARE, LLC
Entity Type:Organization
Organization Name:WINCHESTER CHRISTIAN HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:931-392-4169
Mailing Address - Street 1:5833 AEDC RD
Mailing Address - Street 2:
Mailing Address - City:ESTILL SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37330-3915
Mailing Address - Country:US
Mailing Address - Phone:931-392-4169
Mailing Address - Fax:931-392-4187
Practice Address - Street 1:1764 DECHERD BLVD
Practice Address - Street 2:
Practice Address - City:DECHERD
Practice Address - State:TN
Practice Address - Zip Code:37324-3654
Practice Address - Country:US
Practice Address - Phone:931-392-4169
Practice Address - Fax:931-392-4187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN08316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty