Provider Demographics
NPI:1629818620
Name:ONE HEART PRIMARY CARE, PLLC
Entity type:Organization
Organization Name:ONE HEART PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:865-607-5160
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:OLIVER SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37840-0480
Mailing Address - Country:US
Mailing Address - Phone:865-607-5160
Mailing Address - Fax:
Practice Address - Street 1:515 ROCK BRIDGE RD
Practice Address - Street 2:
Practice Address - City:OLIVER SPRINGS
Practice Address - State:TN
Practice Address - Zip Code:37840-3318
Practice Address - Country:US
Practice Address - Phone:865-432-5161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care