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Individual
AVERY LYNETTE DALE
Active
Individual
AVERY LYNETTE DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
118022
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
24777
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118022
NURSING LICENSE
TN
01
—
24777
ADVANCE PRACTICE REGISTERED NURSE
TN
Enumeration date
08/06/2018
Last updated
02/21/2020
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