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:
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Health care specialties

SpecialtyCodeLicense #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 2 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447362736 NPPES
Tennessee MEDICAID 3973926
Tennessee MEDICAID 3973927
Tennessee MEDICAID 3973925

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