Provider Demographics
NPI:1700181310
Name:WALK-IN CLINIC, INC.
Entity Type:Organization
Organization Name:WALK-IN CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:615-848-8422
Mailing Address - Street 1:5148A MURFREESBORO RD
Mailing Address - Street 2:
Mailing Address - City:LA VERGNE
Mailing Address - State:TN
Mailing Address - Zip Code:37086-2712
Mailing Address - Country:US
Mailing Address - Phone:615-793-3234
Mailing Address - Fax:615-793-2744
Practice Address - Street 1:216 ZOE CT
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-8962
Practice Address - Country:US
Practice Address - Phone:615-848-8422
Practice Address - Fax:615-896-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10576363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty