Individual
KAYLEE BREANNE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 OKOLONA DR, ERWIN, TN 37650-1387
(423) 743-9103
Mailing address
101 OKOLONA DR, ERWIN, TN 37650-1387
(423) 743-9103
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
230562
TN
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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