| NPI | 1053581744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEA NAGEL TERRELL Owner 731-885-9687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN RN92056) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: TN APN6675) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2012-12-04 |