Organization
TN DEPT OF HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA L BRADLEY RN (PHN 3)
(423) 979-4607
Entity
Organization
Contact information
Practice address
1233 SOUTHWEST AVE.EXT., JOHNSON CITY, TN 37604-6519
(423) 979-4607
(423) 979-3261
Mailing address
416 E MAIN ST, JONESBOROUGH, TN 37659-1416
(423) 753-0221
(423) 979-3261
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
RN0000062004
TN
Other
Enumeration date
02/05/2007
Last updated
07/02/2008
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