| NPI | 1316131105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BLAGG Office Manager 901-867-3367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN7796) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2020-08-13 |