| NPI | 1093312498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC ROBERT WATKINS Cmo 615-425-4221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |