| NPI | 1215230461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DUARTE Office Manager 423-580-7320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F1110172) |
| Enumeration Date | 2010-12-09 |
| Last Update Date | 2024-03-18 |