| NPI | 1417652454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN PORTER Manager, Credentialing & Licensing 615-630-0988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-03-31 |
| Last Update Date | 2024-07-30 |