| NPI | 1376912501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE MILLER BOWEN Member 901-486-3480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 13389) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2015-09-17 |