Individual
RAVEN NICOLE BROYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
501 ADESA BLVD, STE A-150, LENOIR CITY, TN 37771
(865) 986-8082
(865) 986-5890
Mailing address
DEPARTMENT 888182, KNOXVILLE, TN 37995-8182
(800) 355-3565
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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