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Organization
WASHINGTON AVE FAMILY PRACTICE
Active
Organization
WASHINGTON AVE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS HASH (OFFICE MANAGER)
(931) 526-4004
Entity
Organization
Contact information
Practice address
67 N WASHINGTON AVE, COOKEVILLE, TN 38501-3371
(931) 526-4004
(931) 526-4014
Mailing address
PO BOX 702, COOKEVILLE, TN 38503-0702
(931) 526-4004
(931) 526-4014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN 93501
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3726167
MEDICARE GROUP PRICING
TN
Enumeration date
10/15/2007
Last updated
10/15/2007
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