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Organization
PAULA VASSAR INC
Active
Organization
PAULA VASSAR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA H VASSAR FNP (PRESIDENT)
(731) 885-6600
Entity
Organization
Contact information
Practice address
1720 E. REELFOOT AVENUE, SUITE 103, UNION CITY, TN 38261-6048
(731) 885-6600
(731) 885-9239
Mailing address
1720 E. REELFOOT AVENUE, SUITE 103, UNION CITY, TN 38261-6048
(731) 885-6600
(731) 885-9239
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
APN00005325
TN
363LF0000X
Family Nurse Practitioner
Primary
RN0000041618
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3160475
BCBS
TN
05
—
3343233
—
TN
01
—
7937258
AETNA
—
Enumeration date
11/16/2005
Last updated
12/05/2023
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