Individual
BEVERLY HILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
921 E 3RD ST, CHATTANOOGA, TN 37403-2102
(423) 290-8253
Mailing address
417 POPE CREEK RD, WILDWOOD, GA 30757-3806
(423) 315-9155
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
193495
TN
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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