Gayle Archer

Individual provider Active NPI Personal Care Attendant · Smithville, TN

NPI 1487969879 · NPPES record last updated Aug 10, 2010

Key facts

NPI
1487969879
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
License
1000000006161 (TN)
Practice address
2323 Students Home Rd
Smithville, TN 37166-7736
Phone
(615) 215-8033
Fax
(615) 215-8033
NPI assigned
Aug 10, 2010
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

State licenses

LicenseStateTypeSpecialty
1000000006161TNMDPersonal Care Attendant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 1000000006161 TN Yes

Addresses

Primary practice location

2323 Students Home Rd
Smithville, TN 37166-7736

Mailing address

2323 Students Home Rd
Smithville, TN 37166-7736
Phone (615) 215-8033

Other identifiers

IdentifierTypeStateIssuer
H445428MedicaidTN

Other providers in Smithville, TN

All providers in Smithville, TN · Personal Care Attendant in Tennessee

Sources for this page

Verify at the official NPI Registry.