Individual
ADRIAN DENISE QUALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2204 PAVILION DR STE 108, KINGSPORT, TN 37660-4651
(423) 392-6100
Mailing address
2204 PAVILION DR STE 108, KINGSPORT, TN 37660-4651
(423) 392-6100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-05493
NC
363A00000X
Physician Assistant
Primary
2921
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q031102
—
TN
Enumeration date
01/15/2015
Last updated
06/30/2022
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