Individual
MRS. JACQUETTA MONIQUE EDWARDS-MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
906 LAVERGNE LN, LA VERGNE, TN 37086-5207
(615) 945-7535
Mailing address
906 LAVERGNE LN, LA VERGNE, TN 37086-5207
(615) 945-7535
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
16732
TN
Other
Enumeration date
10/26/2012
Last updated
10/26/2012
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