Organization
ASSOCIATES IN PRIMARY CARE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA P WATERS N.P. (CEO)
(423) 870-0046
Entity
Organization
Contact information
Practice address
1021 EXECUTIVE DR, SUITE 102, HIXSON, TN 37343-7918
(423) 870-0046
(423) 870-0704
Mailing address
1021 EXECUTIVE DR, SUITE 102, HIXSON, TN 37343-7918
(423) 870-0046
(423) 870-0704
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
40095
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40095
STATE LIC
TN
01
—
PO8840
UPIN
—
Enumeration date
03/20/2008
Last updated
07/10/2008
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