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Individual
ETHAN JAMES GULLEY
Active
Individual
ETHAN JAMES GULLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
215339
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
30497
TN
Other
Enumeration date
04/17/2020
Last updated
03/18/2025
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