Individual
CHARITY REASONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
367 HOSPITAL BLVD, JACKSON, TN 38305-2080
(731) 661-2345
(731) 661-2346
Mailing address
2525 E CAMELBACK RD, SUITE 1100, PHOENIX, AZ 85016-4219
(602) 778-3600
(602) 778-3602
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
136978
TN
Other
Enumeration date
01/14/2013
Last updated
01/31/2013
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