| NPI | 1750556148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA WILDER Shareholder 901-857-8925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN6154) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |