Stacy Anderson

Individual provider Active NPI Attendant Care Provider · Lynnville, TN

NPI 1063199768 · NPPES record last updated Jul 3, 2023

Key facts

NPI
1063199768
Entity type
Individual (NPI type 1)
Primary specialty
Attendant Care Provider 3747A0650X
Practice address
244 Church St
Lynnville, TN 38472-3115
Phone
(919) 649-2695
NPI assigned
Jul 3, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X Yes

Addresses

Primary practice location

244 Church St
Lynnville, TN 38472-3115

Mailing address

139 Pierce Rd
Pulaski, TN 38478-8229

Other providers in Lynnville, TN

All providers in Lynnville, TN · Attendant Care Provider in Tennessee

Sources for this page

Verify at the official NPI Registry.