| Mountain Medicine Integrative Wellness | |
|
58 W First St Crossville TN 38555-4443 | |
| (931) 710-5483 | |
| Not Available |
| Full Name | Mountain Medicine Integrative Wellness |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 58 W First St, Crossville, Tennessee |
| Authorized Official Name and Position | Dale Cuva (NURSE PRACTITIONER) |
| Authorized Official Contact | 4232209409 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Medicine Integrative Wellness 569 Peavine Firetower Rd Crossville TN 38571-0997 Ph: () - | Mountain Medicine Integrative Wellness 58 W First St Crossville TN 38555-4443 Ph: (931) 710-5483 |
| NPI Number | 1811687890 |
|---|---|
| Provider Enumeration Date | 05/11/2023 |
| Last Update Date | 10/07/2024 |
| Medicare PECOS PAC ID | 7719346089 |
|---|---|
| Medicare Enrollment ID | O20230705000777 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811687890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Dale Cuva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336500834 PECOS PAC ID: 2466751375 Enrollment ID: I20160427001890 |
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