| NPI | 1407121635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY DENISE BALLARD Provider 931-392-4749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN APN08389) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2023-03-30 |