Individual
MR. JOE TAYLOR PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
804 BRISTOL CAVERNS HWY, BRISTOL, TN 37620-9456
(423) 534-6322
Mailing address
804 BRISTOL CAVERNS HWY, BRISTOL, TN 37620-9456
(423) 534-6322
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
222207
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
36044
TN
Other
Enumeration date
02/14/2023
Last updated
06/27/2024
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