| NPI | 1679230940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN PORTER Credentialing Manager 615-630-0988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2023-07-10 |