| NPI | 1992575203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA TIDWELL JANICEK Ap RN/Co Owner 615-239-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2025-04-24 |