Individual
JAMES CLARK CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
457 VISTA DR, SPARTA, TN 38583-1360
(931) 738-3383
Mailing address
1609 FARMINGTON DR, COOKEVILLE, TN 38501-0743
(931) 644-2463
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26091
TN
Other
Enumeration date
06/29/2019
Last updated
06/29/2019
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