Individual
BRENDA MARIE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
334 EAGLE LN, EVENSVILLE, TN 37332
(423) 775-7819
(423) 775-8078
Mailing address
334 EAGLE LN, EVENSVILLE, TN 37332
(423) 775-7819
(423) 775-8078
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000094744
TN
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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