Organization · Type 2 NPI
East Tennessee State University
Federally Qualified Health Center (FQHC) · Johnson City, TN
NPI number
1093990608
Active
Practice location
202 W Fairview Ave
Johnson City, TN 37604-5611
Fax (423) 434-0666
Mailing address
365 Stout Drive Box 70403
Johnson City, TN 37614-1703
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
7 other providers at this address
- Amanda S. Moorhouse, APNFamily Nurse Practitioner Johnson City, TN NPI 1679889356
- Christina L. Dzioba, FNP, WHNP-BC, C-EFMFamily Nurse Practitioner Johnson City, TN NPI 1598180614
- Janice Lynn Lazear, CRNPNurse Practitioner Johnson City, TN NPI 1699921981
- Jennifer Lyn Whitehead, LCSWClinical Social Worker Johnson City, TN NPI 1720550288
- Jessica Beth GreenStudent in an Organized Health Care Education/Training Program Johnson City, TN NPI 1790694503
- Laura Jessica Templeton, NP-CFamily Nurse Practitioner Johnson City, TN NPI 1194238071
- Meredith McCook Prosak, LCSWClinical Social Worker Johnson City, TN NPI 1932861671
Other federally qualified health center (fqhc) providers in Johnson City
About NPI 1093990608
East Tennessee State University's National Provider Identifier is 1093990608, issued on Jan 2, 2008. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Johnson City, TN. The record was last updated on Jul 21, 2022.