Organization
HIDDEN PATHS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY BANHAM DNP, APRN, FNP-C (OWNER)
(901) 216-4354
Entity
Organization
Contact information
Practice address
7516 ENTERPRISE AVE # 1, GERMANTOWN, TN 38138-3802
(901) 757-2249
Mailing address
PO BOX 269, ELLENDALE, TN 38029-0269
(901) 216-4354
(888) 858-1577
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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