| NPI | 1144080060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN RAYMOND JONES Owner 423-320-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-03-19 |