Individual
JODIE HEATHER MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
430 COLLEGE ST, NEWPORT, TN 37821-3752
(423) 623-8733
Mailing address
430 COLLEGE ST, NEWPORT, TN 37821-3752
(423) 623-8733
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
0000131269
TN
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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