NPI | 1447769559 |
---|---|
Entity Type | Organization |
Authorized Contact | SYDNI CLEMMONS Credentialing Manager 901-351-1791 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
Additional Taxonomies | 261Q00000X Clinic/Center |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2017-09-21 |
Last Update Date | 2021-10-15 |