| NPI | 1023216249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS SHELLY VP & General Manager 615-425-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ OTC 4233) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ OTC 4233) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2025-10-22 |