| NPI | 1124322474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEAH MICHELLE SMITH Credentialing Manager 901-205-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2023-11-13 |