NPI | 1821523101 |
---|---|
Entity Type | Organization |
Authorized Contact | DEAVER T SHATTUCK President 865-633-9068 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
363LF0000X Nurse Practitioner, Family | |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
Enumeration Date | 2017-04-25 |
Last Update Date | 2017-06-20 |