| Premise Health Wellness Center - Brentwood Nearsite | |
|
5410 Maryland Way Brentwood TN 37027 | |
| (615) 468-6592 | |
| Not Available |
| Full Name | Premise Health Wellness Center - Brentwood Nearsite |
|---|---|
| Speciality | Clinic/Center |
| Location | 5410 Maryland Way, Brentwood, Tennessee |
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Wellness Center - Brentwood Nearsite 5500 Maryland Way Ste 400 Brentwood TN 37027-4948 Ph: () - | Premise Health Wellness Center - Brentwood Nearsite 5410 Maryland Way Brentwood TN 37027 Ph: (615) 468-6592 |
| NPI Number | 1396100665 |
|---|---|
| Provider Enumeration Date | 12/30/2015 |
| Last Update Date | 09/15/2022 |
| Medicare PECOS PAC ID | 3072744184 |
|---|---|
| Medicare Enrollment ID | O20240403002010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396100665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Deanna B Womble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720211469 PECOS PAC ID: 1658418108 Enrollment ID: I20091102000433 |
| Provider Name | Angela M Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013182476 PECOS PAC ID: 5092981886 Enrollment ID: I20111228000501 |
| Provider Name | Rosalind K. Womack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508093816 PECOS PAC ID: 6507910072 Enrollment ID: I20180811000098 |
| Provider Name | Syra Linn York |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689359580 PECOS PAC ID: 9931548278 Enrollment ID: I20240418003115 |
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