| NPI | 1134795628 |
|---|---|
| Doing Business As | PROVIDENCE HEALTH |
| Entity Type | Organization |
| Authorized Contact | IRENE WILSON Fnp C 901-486-0439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2021-06-03 |