| 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 |