Individual
KATRINA COLLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
450 HATMAKER RIDGE RD, JACKSBORO, TN 37757-3708
(423) 201-1096
Mailing address
450 HATMAKER RIDGE RD, JACKSBORO, TN 37757-3708
(423) 201-1096
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0000073250
TN
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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