Forrester, Otis Brandon
Forrester, Otis Brandon is an individual health care provider with primary practice located at 102 Dunhill Pl Nw , Cleveland TN 37311-3885. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Forrester, Otis Brandon can be contacted via phone (423) 339-9581.Contact Information
Primary practice address
102 Dunhill Pl Nw
Cleveland TN 37311-3885
Phone: (423) 339-9581
Fax: (423) 472-0494
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 29396 | Tennessee |
Profile Details
NPI number | 1447362736 |
---|---|
LBN Legal business name | Forrester, Otis Brandon |
Credentials | FNP-C |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 31st, 2006 |
Last updated | Jul 19th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1447362736 | NPPES |
Tennessee | MEDICAID | 3973926 | |
Tennessee | MEDICAID | 3973927 | |
Tennessee | MEDICAID | 3973925 |
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