| NPI | 1174035075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HALEY D QUILLEN Owner 423-340-1764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16881) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2023-06-29 |