| NPI | 1912894783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE HICKS Controller 615-988-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 261QU0200X Clinic/Center Urgent Care | |
| 261QP2300X Clinic/Center Primary Care | |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2025-06-23 |