Organization
SALLIE EARLY HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLIE EARLY TUCKER APN (OWNER)
(865) 558-1584
Entity
Organization
Contact information
Practice address
1802 NEVA CT, MANDEVILLE, LA 70448-1026
(865) 588-1584
Mailing address
1802 NEVA CT, MANDEVILLE, LA 70448-1026
(865) 588-1584
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
APN0000007667
TN
207Q00000X
Family Medicine Physician
Primary
APN0000007667
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3714700
—
TN
Enumeration date
02/26/2008
Last updated
02/26/2008
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