Organization
BANYAN FAMILY NIGHT CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY WINGO-SALMOND MSN, FNP (PROVIDER/OWNER)
(423) 284-3157
Entity
Organization
Contact information
Practice address
276B JAMES ASBURY DR NW, CLEVELAND, TN 37312-2984
(423) 464-5776
(423) 464-5665
Mailing address
276B JAMES ASBURY DR NW, CLEVELAND, TN 37312-2984
(423) 464-5776
(423) 464-5665
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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