Individual
MRS. MATTISON ROGERS STARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1420 TUSCULUM BLVD, GREENEVILLE, TN 37745-4279
(423) 787-5000
Mailing address
345 STARNES LN, GREENEVILLE, TN 37745-2179
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4614
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1183325
NCCPA ID
—
01
—
4614
TENNESSEE LICENSE NUMBER
TN
Enumeration date
06/15/2021
Last updated
11/21/2022
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