Individual
KACI LAUREN HENARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2205 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2904
(423) 352-6500
Mailing address
115 W ASH ST, LA FOLLETTE, TN 37766-3511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
206383
TN
363LF0000X
Family Nurse Practitioner
Primary
30910
TN
Other
Enumeration date
12/13/2021
Last updated
11/14/2023
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