Organization
DIABETES CENTER OF JACKSON, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY D LITTLE ANP-BC, BC-ADM (OWNER)
(731) 602-2778
Entity
Organization
Contact information
Practice address
2782 N HIGHLAND AVE STE C, JACKSON, TN 38305-1797
(731) 602-2778
Mailing address
214 CHARLES LATHAM DR, JACKSON, TN 38301-9049
(731) 602-2778
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/10/2018
Last updated
03/28/2018
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