| NPI | 1295223279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARTLEY TEAGUE Executive Director 731-512-1277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 363LW0102X Nurse Practitioner, Women's Health | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2024-03-06 |