Individual
MATTHEW LEE LUTTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 422-0213
(731) 422-5743
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 425-5752
(731) 422-5743
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
27140
TN
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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