| Hwv Primary Care Clinic, Pllc | |
|
3139 Lebanon Pike Nashville TN 37214-2314 | |
| (615) 357-0139 | |
| (615) 357-0257 |
| Full Name | Hwv Primary Care Clinic, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3139 Lebanon Pike, Nashville, Tennessee |
| Authorized Official Name and Position | Deressa Lee Marshall (OWNER/APRN) |
| Authorized Official Contact | 7313262503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hwv Primary Care Clinic, Pllc Po Box 871 Madison TN 37116-0871 Ph: (615) 357-0139 | Hwv Primary Care Clinic, Pllc 3139 Lebanon Pike Nashville TN 37214-2314 Ph: (615) 357-0139 |
| NPI Number | 1073050951 |
|---|---|
| Provider Enumeration Date | 01/30/2017 |
| Last Update Date | 07/26/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073050951 | NPI | - | NPPES |
| Q041062 | Medicaid | TN | |
| Q041043 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
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