Provider Demographics
NPI:1982980231
Name:HEALTH PARTNERS OF TENNESSEE LLC
Entity Type:Organization
Organization Name:HEALTH PARTNERS OF TENNESSEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:B
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:865-202-6205
Mailing Address - Street 1:137 DE ARMOND RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-6415
Mailing Address - Country:US
Mailing Address - Phone:865-202-6205
Mailing Address - Fax:865-717-6676
Practice Address - Street 1:137 DE ARMOND RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-6415
Practice Address - Country:US
Practice Address - Phone:865-202-6205
Practice Address - Fax:865-717-6676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty