| NPI | 1720363187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA MICHELE BANKS Nurse Practitioner 901-726-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16114) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2011-10-18 |