| NPI | 1952724213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDIE D JENKINS Gm 423-877-3568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 8749977) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN PA0000000981) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-01-22 |