Organization
GREENBRIER MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ANN LARGE MSN, FNP (FAMILY NURSE PRACTITIONER)
(865) 453-0792
Entity
Organization
Contact information
Practice address
1110 VILLAGE DR, SEVIERVILLE, TN 37862-5028
(865) 453-0792
(865) 429-5006
Mailing address
1110 VILLAGE DR, SEVIERVILLE, TN 37862-5028
(865) 453-0792
(865) 429-5006
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
13614
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APN 13614
LICENSE
TN
Enumeration date
07/30/2013
Last updated
07/30/2013
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