Organization
SLEEP PROFESSIONALS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN L. WHALEY (CEO)
(931) 205-8774
Entity
Organization
Contact information
Practice address
1750 MEMORIAL DR, CLARKSVILLE, TN 37043-6356
(931) 614-6324
(931) 233-2195
Mailing address
1750 MEMORIAL DR, CLARKSVILLE, TN 37043-6356
(931) 614-6324
(931) 233-2195
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103G477206
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
TN
05
—
1526366
—
TN
01
—
4311476
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
Enumeration date
02/05/2011
Last updated
03/09/2012
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