| NPI | 1073246773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE HICKS Controller 615-988-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2025-03-13 |