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1639835895
LOGAN NICOLE THOMAS
JOHNSON CITY, TN
NPI
1639835895
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Former Name
LOGAN CROUCH
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: TN 30187)
Enumeration Date
2021-11-11
Last Update Date
2022-08-10
Business Address
LOGAN NICOLE THOMAS
329 WESLEY ST
JOHNSON CITY, TN 37601-1772
Phone number: 423-631-0055
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Mailing Address
LOGAN NICOLE THOMAS
119 EPPERSON ST
ATHENS, TN 37303-3478
Phone number: 423-745-7500
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