| NPI | 1730368408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE S JOBE Practice Manager 865-220-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: TN 0000011062) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2008-01-09 |