Individual
MRS. KACI ELIZABETH WALDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
334 EAGLE LANE, EVENSVILLE, TN 37332
(423) 775-7819
Mailing address
334 EAGLE LANE, EVENSVILLE, TN 37332
(423) 775-7819
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000096574
TN
Other
Enumeration date
04/12/2022
Last updated
04/12/2022
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