Individual
PAULA COUNTISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 MEDICAL PARK BLVD, SUITE 458-W, BRISTOL, TN 37620-7430
(423) 844-4975
(423) 844-4987
Mailing address
2050 MEADOWVIEW PKWY, KINGSPORT, TN 37660-7332
(423) 230-5000
(423) 230-5010
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5263
TN
363LF0000X
Family Nurse Practitioner
5263
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3345927
—
TN
Enumeration date
07/12/2006
Last updated
10/23/2007
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