| NPI | 1740691567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MARTIN Owner/Clinic Administrator 901-881-5819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 11700) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2021-01-30 |