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1225670128
ALICIA DEIRTH
KINGSPORT, TN
NPI
1225670128
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TN APN0000025715)
Enumeration Date
2019-10-11
Last Update Date
2024-08-16
Business Address
ALICIA DEIRTH
2202 N JOHN B DENNIS HWY STE 100
KINGSPORT, TN 37660-5904
Phone number: 423-578-8500
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Mailing Address
ALICIA DEIRTH
1021 W OAKLAND AVE STE 310
JOHNSON CITY, TN 37604-2192
Phone number: 423-302-6565
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