| NPI | 1689720146 |
|---|---|
| Former Name | TERESA DIANE SPARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WC1500X Registered Nurse, Community Health (Licence: TN RN0000100595) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |