Individual
TANYA RAE LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN RN
Contact information
Practice address
154 BLOUNTVILLE BYPASS, BLOUNTVILLE, TN 37617
(423) 279-2658
Mailing address
368A SHANKS RD, BLOUNTVILLE, TN 37617-6536
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000154662
TN
Other
Enumeration date
02/13/2007
Last updated
07/09/2007
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