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1295263192
ELIZABETH ILLENBERG
TULLAHOMA, TN
NPI
1295263192
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: TN 22622)
Enumeration Date
2017-05-23
Last Update Date
2017-05-23
Business Address
ELIZABETH ILLENBERG FNP
600 N JACKSON ST
TULLAHOMA, TN 37388-3542
Phone number: 931-563-5469
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Mailing Address
ELIZABETH ILLENBERG FNP
151 EDNA W GROOMS LN
WATERTOWN, TN 37184-1078
Phone number:
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