Provider Demographics
NPI:1033936786
Name:HAPPY HEALTH MANAGEMENT OF TENNESSEE LLC
Entity type:Organization
Organization Name:HAPPY HEALTH MANAGEMENT OF TENNESSEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDKIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-750-9294
Mailing Address - Street 1:181 DARDEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:DRIFTWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78619-9770
Mailing Address - Country:US
Mailing Address - Phone:512-750-9294
Mailing Address - Fax:
Practice Address - Street 1:9125 CROSS PARK DR STE 150
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4563
Practice Address - Country:US
Practice Address - Phone:512-517-6626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty