Earl Dan Bembry, PHD, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · New Tazewell, TN
NPI 1952407124 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1952407124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APN0000011921 (TN)
- Practice address
- 4940 Highway 33 S
New Tazewell, TN 37825-2631 - Phone
- (423) 526-0009
- Fax
- (423) 526-2047
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11921 | TN | MD | Dentist |
| APN0000011921 | TN | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APN0000011921 | TN | Yes |
Addresses
Primary practice location
4940 Highway 33 S
New Tazewell, TN 37825-2631
Mailing address
4940 Highway 33 South
New Tazewell, TN 37825
Phone (423) 526-0009
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3348015 | Medicaid | TN | |
| APN11921 | Other | TN | APN LICENSE |
Other providers in New Tazewell, TN
- Mary Banks
- Sarah Lee Barnard
- Tina K Barnett
- Mark Barton
- Alexa Jade Bayless
- Sheryl Ann Bishop
- Amber Blevins
- Quinn F Bowring
- William Herbert Brooks
- Juanita M Brown
All providers in New Tazewell, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.