| NPI | 1861726812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH WILSON Chief Manager 901-590-2747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 11927) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TN MD27723) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2010-07-12 |