| NPI | 1508498080 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | FESTUS C OBONNA Mental Health Nurse Practitioner 865-696-9226 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Enumeration Date | 2020-02-12 | 
| Last Update Date | 2020-02-12 |