| NPI | 1710761127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE FARRIS Pediatric Nurse Practitioner 901-409-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2023-08-24 |