| NPI | 1366648040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARYN HAWTHORNE Vice President Finance 865-541-8181 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 363LP0200X Nurse Practitioner Pediatrics | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2023-06-08 |