MAYLEE GRACE MIRACLE

BRISTOL, TN
NPI1275224594
Former NameMAYLEE G HAYNES
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TN  34099)
Additional Taxonomies163W00000X Registered Nurse
(Licence: TN  0000245367)
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: VA  0024192489)
Enumeration Date2023-05-17
Last Update Date2025-02-05
Business Address
MAYLEE GRACE MIRACLE PMHNP-BC
739 BLUFF CITY HWY STE 3
BRISTOL, TN 37620-4637
Phone number: 423-534-9195
Mailing Address
MAYLEE GRACE MIRACLE PMHNP-BC
926 W OAKLAND AVE STE 202
JOHNSON CITY, TN 37604-1445
Phone number: 423-850-1150