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Organization

CUMBERLAND GAP MEDICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA SUE COLLINS NP (NURSE PRACTITIONER)
(423) 201-9799
Entity
Organization

Contact information

Practice address
502 W CENTRAL AVE, SUITE 2, LA FOLLETTE, TN 37766-3400
(423) 201-9799
(423) 437-8162
Mailing address
502 W CENTRAL AVE, SUITE 2, LA FOLLETTE, TN 37766-3400
(423) 201-9799
(423) 437-8162

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000016605
TN

Other

Enumeration date
02/12/2014
Last updated
02/12/2014
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