| NPI | 1144956392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE MICHELLE JOHNSON Nurse Practitioner 901-208-6984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2022-07-29 |