Individual
KEVIN JORDAN WENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ASN
Contact information
Practice address
1596 HIGHWAY 33 S, NEW TAZEWELL, TN 37825-7104
(423) 626-8271
(423) 626-0688
Mailing address
DEPARTMENT 888182, KNOXVILLE, TN 37995-8182
(800) 355-3565
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN163635
TN
Other
Enumeration date
03/17/2008
Last updated
03/17/2008
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