| Emerald Primary Care And Wellness Clinic, Pllc | |
|
815 Needham Dr Smyrna TN 37167-9403 | |
| (601) 672-9730 | |
| Not Available |
| Full Name | Emerald Primary Care And Wellness Clinic, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 815 Needham Dr, Smyrna, Tennessee |
| Authorized Official Name and Position | Centeria Green Woolfolk (OWNER/ FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 6016729730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Primary Care And Wellness Clinic, Pllc 1130 Britannia Way Murfreesboro TN 37129-3791 Ph: (601) 672-9730 | Emerald Primary Care And Wellness Clinic, Pllc 815 Needham Dr Smyrna TN 37167-9403 Ph: (601) 672-9730 |
| NPI Number | 1932790128 |
|---|---|
| Provider Enumeration Date | 01/29/2021 |
| Last Update Date | 03/29/2021 |
| Medicare PECOS PAC ID | 2062820046 |
|---|---|
| Medicare Enrollment ID | O20210412000655 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932790128 | NPI | - | NPPES |
| 1104343318 | Other | TN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Centeria Green Woolfolk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104343318 PECOS PAC ID: 6305112988 Enrollment ID: I20171026000790 |
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