MEMORIAL CLINIC P.C. (NPI# 1154353092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154353092 |
| Entity Type | Organization |
| Organization Name | MEMORIAL CLINIC P.C. |
| Practice Address |
203 E Commerce St Waverly TN 37185-1629 |
| Practice Telephone | 9312965833 |
| Practice Fax Number | 9312967388 |
| Mailing Telephone | 9312965833 |
| Mailing Fax Number | 9312967388 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2015-04-16 |
| Authorized Official Name | BONNIE SUE JUDD (OWNER) |
| Authorized Official Telephone | 9312965833 |
| Authorized Official Credential | APN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 36404232 | 05 |
| Street Address |
203 E COMMERCE ST |
| City | WAVERLY |
| State | TN |
| Zip Code | 37185-1629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679978050 | Jessica Mcneil | Nurse Practitioner | 203 E Commerce St, Waverly, TN 37185-1629 | 2014-10-28 |
| 1912922816 | Bonnie Sue Judd | Nurse Practitioner | 203 E Commerce St, Waverly, TN 37185-1629 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104295567 | Tiffany Szabo | Speech-Language Pathologist | 670 Tn- 13, Waverly, TN 37185 | 2015-09-16 |
| 1407266653 | Wallace Mcclure | General Practice | 450 Powers Blvd., Waverly, TN 37185 | 2014-04-28 |
| 1982995346 | Laurel Lea Barrier | Speech-Language Pathologist | 1171 Lockhart Road, Waverly, TN 37185 | 2011-04-20 |
| 1477703155 | Christie Madge King-patterson | Nurse Practitioner | 215b Holly Lane, Waverly, TN 37185 | 2008-09-30 |
| 1396921946 | Tammy Jo Saffel | Counselor | 205b East Main Street, Waverly, TN 37185 | 2008-01-14 |
| 1386794816 | Lawrence Richard Jackson Jr. | Family Medicine | 102 Hillwood Dr, Waverly, TN 37185 | 2007-01-10 |
| 1720147119 | Kelley M Blackwell | Marriage & Family Therapist | 795 Holly Ln, Waverly, TN 37185 | 2006-12-08 |
| 1063509578 | Ida Suellen Westerman | Counselor | 205 B East Main Street, Waverly, TN 37185 | 2006-10-06 |
| 1801835962 | Noel R Dominguez | Internal Medicine | 209 West Main Street, Waverly, TN 37185 | 2006-06-05 |
| 1730145822 | Waverly Health Care and Rehabilitation Center Inc | Skilled Nursing Facility | 895 Powers Blvd, Waverly, TN 37185 | 2006-04-26 |
| Find all providers in zip 37185 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033442520 | April L. Mclevain | Nurse Practitioner | 4380 State Route 359, Waverly, KY 42462 | 2009-09-15 |
| 1477703155 | Christie Madge King-patterson | Nurse Practitioner | 215b Holly Lane, Waverly, TN 37185 | 2008-09-30 |
| 1710038989 | Jennifer Lee Gerber | Nurse Practitioner | 104 Hillwood Dr, Waverly, TN 37185-2116 | 2007-01-15 |
| 1548340078 | Mary B. Davis | Nurse Practitioner | 725 Holly Ln, Waverly, TN 37185-3284 | 2006-10-17 |
| 1346205796 | Dorothy L Dighton | Nurse Practitioner | Missouri St & Hwy 24, Waverly, MO 64096 | 2006-04-19 |
| 1528027562 | Nancy S. Kemp | Nurse Practitioner | 29 N Chemung St, Waverly, NY 14892-1211 | 2006-03-20 |
| 1447869821 | Rachel Cloke | Nurse Practitioner | 29 N Chemung St, Waverly, NY 14892-1211 | 2020-07-30 |
| 1285264630 | Ellen Elizabeth Jacque | Nurse Practitioner | 312 9th St Sw, Waverly, IA 50677-2999 | 2020-01-23 |
| 1114571536 | Ashlin Underwood | Nurse Practitioner | 301 W Main St, Waverly, TN 37185-1512 | 2019-07-25 |
| 1932672763 | Nnebuisi Alaedu | Nurse Practitioner | 24427 Mussellwhite Dr, Waverly, VA 23891-2222 | 2019-01-03 |
| Find all providers in WAVERLY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.