Individual
KATHLEEN WYKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-6111
Mailing address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-6111
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
235803
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
35209
TN
Other
Enumeration date
03/28/2022
Last updated
12/15/2023
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