Individual
MRS. TABITHA JO SIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4700 MUELLER BRASS RD, COVINGTON, TN 38019-3754
(901) 476-0235
Mailing address
90 VANDY AVE, COVINGTON, TN 38019-7184
(901) 606-6331
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN000077163
TN
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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