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2151 Century Ln Johnson City TN 37604-4469 | |
| (423) 926-2500 | |
| (423) 926-5999 |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 2151 Century Ln, Johnson City, Tennessee |
| Authorized Official Name and Position | Betty J. King (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4234394414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
365 Stout Drive, Box 70403 Johnson City TN 37614 Ph: (423) 433-6141 | 2151 Century Ln Johnson City TN 37604-4469 Ph: (423) 926-2500 |
| NPI Number | 1124593132 |
|---|---|
| Provider Enumeration Date | 10/05/2018 |
| Last Update Date | 10/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124593132 | NPI | - | NPPES |
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