Organization
NEWBERN MEDICAL CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY MCCANN FNP (OWNER/PRESIDENT)
(731) 627-0734
Entity
Organization
Contact information
Practice address
105 N MONROE ST, NEWBERN, TN 38059-1214
(731) 627-0734
(731) 627-0736
Mailing address
105 N MONROE ST, NEWBERN, TN 38059-1214
(731) 627-0734
(731) 627-0736
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
APN5297
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3727670
MEDICARE
TN
Enumeration date
08/20/2007
Last updated
08/20/2007
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