Individual
TERI GOURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
250 DAWSON ST, VONORE, TN 37385
(423) 884-3180
Mailing address
250 DAWSON ST, VONORE, TN 37385
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
81966
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81966
NURSING LICENSE
TN
Enumeration date
01/11/2017
Last updated
01/11/2017
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