| NPI | 1669104196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARYN HAWTHORNE Vice President Finance 865-541-8181 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 363LP0200X Nurse Practitioner Pediatrics | |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2023-06-08 |