| NPI | 1770971533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ANDRE CARPENTER Chief Operating Officer 901-463-0105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 6284) |
| Enumeration Date | 2015-01-02 |
| Last Update Date | 2023-08-22 |