| NPI | 1184834541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA M WADE Practitioner 865-882-2002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN000005322) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-02-04 |