| NPI | 1134534415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FIELDS Medical Director 865-240-4802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 17485) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2014-06-25 |