Provider Demographics
NPI:1710312509
Name:AFTER WORK FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:AFTER WORK FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:DAN
Authorized Official - Last Name:BEMBRY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:1423-526-0009
Mailing Address - Street 1:4940 HIGHWAY 33 S
Mailing Address - Street 2:
Mailing Address - City:NEW TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37825-2631
Mailing Address - Country:US
Mailing Address - Phone:142-352-6000
Mailing Address - Fax:
Practice Address - Street 1:4940 HIGHWAY 33 S
Practice Address - Street 2:
Practice Address - City:NEW TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37825-2631
Practice Address - Country:US
Practice Address - Phone:142-352-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-11
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000011921363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty