Provider Demographics
NPI:1386260792
Name:ANEW FAMILY MEDICAL PLLC
Entity type:Organization
Organization Name:ANEW FAMILY MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOORE-RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-989-2829
Mailing Address - Street 1:111 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-2313
Mailing Address - Country:US
Mailing Address - Phone:731-989-2829
Mailing Address - Fax:731-520-0230
Practice Address - Street 1:111 FRONT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TN
Practice Address - Zip Code:38340-2313
Practice Address - Country:US
Practice Address - Phone:731-989-2829
Practice Address - Fax:731-520-0230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty