Shelbyville Hospital Corporation

Organization Active NPI Nurse Practitioner · Wartrace, TN

NPI 1487716890 · NPPES record last updated Jul 8, 2008

Key facts

NPI
1487716890
Entity type
Organization (NPI type 2)
Primary specialty
Nurse Practitioner 363L00000X
Legal business name
SHELBYVILLE HOSPITAL CORPORATION
Practice address
507 Blackman Blvd W
Wartrace, TN 37183-2210
Phone
(931) 389-0600
Fax
(931) 389-6781
NPI assigned
Dec 14, 2006
Organization subpart
Yes
Parent organization (as reported)
SHELBYVILLE HOSPITAL CORPORATION

Authorized official

Name
Jennifer Bombardi-Mount, CFNP
Title
Nurse Practitioner
Phone
(931) 389-0600

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Lynchburg Family Medicine (9 organizations share this tax ID)
Part of
Lynchburg Family Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363L00000X TN Yes

Addresses

Primary practice location

507 Blackman Blvd W
Wartrace, TN 37183-2210

Mailing address

PO Box 403621
Atlanta, GA 30384-3621
Phone (931) 389-0600

Other names

  • Wartrace Family Practice Center Doing business as

Other providers in Wartrace, TN

All providers in Wartrace, TN · Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.