NPI | 1366805525 |
---|---|
Entity Type | Organization |
Authorized Contact | SUSAN JOHNSTON Apn/Owner 865-382-3531 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN16191) |
Enumeration Date | 2016-04-04 |
Last Update Date | 2016-04-04 |