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Individual

NAN M. GAYLORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, RN, CPNP

Contact information

Practice address
220 LANGLAND ST, KNOXVILLE, TN 37915-1415
(865) 594-5078
(865) 594-3921
Mailing address
1200 VOLUNTEER BLVD, UTCON #335, KNOXVILLE, TN 37996-4180
(865) 974-7622
(865) 974-3569

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000044603
TN
363LP0200X
Pediatric Nurse Practitioner
APN0000005409
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3497038
TN
Enumeration date
06/08/2005
Last updated
08/03/2011
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