Individual
MS. JEANNIE LORAINE SOUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4850 E ANDREW JOHNSON HWY, GREENEVILLE, TN 37745-3098
(423) 787-6641
Mailing address
3518 BLUE SPRINGS PKWY, GREENEVILLE, TN 37743-3058
(423) 741-3267
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
70075
TN
Other
Enumeration date
03/03/2012
Last updated
03/03/2012
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