Individual
AUTUMN MAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4589 RHEA COUNTY HWY, DAYTON, DAYTON, TN 37321-6076
(931) 507-1212
(931) 507-1217
Mailing address
153 HIRAM GREEN LN, DAYTON, DAYTON, TN 37321-7650
(423) 356-7657
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
87723
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87723
LPN LICENSE
TN
Enumeration date
02/02/2016
Last updated
02/02/2016
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