Organization
EAST TENNESSEE STATE UNIVERSITY
Active
Other names
David Crockett High School Based Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETTY J. KING (ACTING CHIEF FINANCIAL OFFICER)
(423) 439-4414
Entity
Organization
Contact information
Practice address
684 OLD STATE ROUTE 34, JONESBOROUGH, TN 37659-6094
(423) 753-0057
(423) 753-1167
Mailing address
365 STOUT DRIVE BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4071
(423) 439-4060
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/20/2009
Last updated
02/23/2017
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