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Individual

STEPHANIE COUSINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
833 LAWRENCE AVE, MARYVILLE, TN 37803-4857
(865) 982-7121
Mailing address
330 MELROSE ST, MARYVILLE, TN 37803-4814
(865) 981-5741

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
978561
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
978561
TENNESSEE BOARD OF NURSING
TN
Enumeration date
03/29/2022
Last updated
03/29/2022
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