Individual
JACOB BRIAN MATHIEU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1787 VETERANS BLVD STE 101, SEVIERVILLE, TN 37862-6946
(865) 428-2773
Mailing address
8047 DENNIS FOX LN, KNOXVILLE, TN 37938-3363
(985) 855-2976
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
36790
TN
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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