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Organization
ICP TENNESSEE, LLC
Active
Organization
ICP TENNESSEE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY THOMASON (AUTHORIZED OFFICIAL)
(855) 498-6767
Entity
Organization
Contact information
Practice address
200 PROSPERITY PLACE, KNOXVILLE, TN 37923
(855) 498-6767
(479) 968-1673
Mailing address
PO BOX 9178, RUSSELLVILLE, AR 72811-9178
(855) 498-6767
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
—
TN
Other
Enumeration date
05/19/2014
Last updated
05/12/2021
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