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Organization
TENNESSEE CONVENIENCE CARE LLC
Active
Organization
TENNESSEE CONVENIENCE CARE LLC
Active
Other names
Tennessee Convenience Care
Organization subpart
No
Provider details
NPI number
Authorized official
LORA F ELKINS (CEO)
(931) 526-1050
Entity
Organization
Contact information
Practice address
315 N WASHINGTON AVE STE 130, COOKEVILLE, TN 38501-2623
(931) 526-1050
(931) 526-8163
Mailing address
315 N WASHINGTON AVE STE 130, COOKEVILLE, TN 38501-2623
(931) 526-1050
(931) 526-8163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18488
TN
363L00000X
Nurse Practitioner
13278
TN
363L00000X
Nurse Practitioner
17011
TN
Other
Enumeration date
03/24/2015
Last updated
03/24/2015
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