| NPI | 1336503564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIESL R BULLEN Sole Member/Provider 901-758-0280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 11962) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-07-27 |