| NPI | 1760884175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN PORTER Manager, Credentialing & Licensing 615-630-0988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2024-07-30 |