| NPI | 1023380474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIMI ANN CHERRY Clinic Manager 731-286-6156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 6331) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |