| NPI | 1457089880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE MICHELLE JOHNSON Nurse Practitioner 901-208-6984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2022-08-12 |