Qualls, Benita K

Qualls, Benita K is an individual health care provider with primary practice located at 1407 W Baddour Pkwy , Lebanon TN 37087-2513. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Qualls, Benita K can be contacted via phone (615) 444-6203.

Contact Information

Primary practice address
1407 W Baddour Pkwy Lebanon TN 37087-2513
Phone: (615) 444-6203
Fax: (615) 444-6252
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 185 Tennessee

Profile Details

NPI number 1629245634
LBN Legal business name Qualls, Benita K
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2008
Last updated Aug 9th, 2011 - about 14 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1629245634 NPPES
Tennessee Other 3323092 UHC
Tennessee MEDICAID 1523861 UHC
Tennessee Other 185 UHC
Tennessee Other 4298144 UHC

Popular Providers