Individual
DIANE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1385 S HIGHLAND AVE STE B1, JACKSON, TN 38301-7547
(731) 427-0470
(731) 427-0995
Mailing address
1385 S HIGHLAND AVE STE B1, JACKSON, TN 38301-7547
(731) 427-0470
(731) 427-0995
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0000243667
TN
363L00000X
Nurse Practitioner
Primary
APN0000036026
TN
Other
Enumeration date
03/02/2023
Last updated
01/16/2025
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