| NPI | 1194308809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY CRANE Owner/President 865-693-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2023-10-13 |