Individual
JAYANNA KAYLEE QUALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
51 SMITH AVE, HOHENWALD, TN 38462-1124
(931) 796-2204
Mailing address
51 SMITH AVE, HOHENWALD, TN 38462-1124
(931) 796-2204
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN00000097016
TN
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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