| NPI | 1235641796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER D ROBERTS Billing/Credentialing 423-736-3649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21594) |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2022-04-20 |