KETSANA BOUTTAVONG

NASHVILLE, TN
NPI1932737954
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TN  27016)
Enumeration Date2020-03-27
Last Update Date2023-09-14
Business Address
KETSANA BOUTTAVONG PMHNP-BC
1310 24TH AVE S
NASHVILLE, TN 37212-2637
Phone number: 615-327-4751
Mailing Address
KETSANA BOUTTAVONG PMHNP-BC
1310 24TH AVE S
NASHVILLE, TN 37212-2637
Phone number: 615-327-4751