Individual
KACEY JO HENLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 HALES RD, JONESBOROUGH, TN 37659-4638
(423) 833-7895
Mailing address
200 HALES RD, JONESBOROUGH, TN 37659-4638
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
259245
TN
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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