Individual
STACYE JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
301 TYSON AVE, PARIS, TN 38242-4544
(731) 644-1220
Mailing address
301 TYSON AVENUE, PARIS, TN 38242
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0000012607
TN
Other
Enumeration date
04/13/2007
Last updated
05/13/2014
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