Individual
AMY HENEGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 OLD SIAM RD, ELIZABETHTON, TN 37643-4724
(423) 747-7859
Mailing address
220 OLD SIAM RD, ELIZABETHTON, TN 37643-4724
(423) 747-7859
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
128169
TN
Other
Enumeration date
11/29/2021
Last updated
11/29/2021
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