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Individual

SALLY ANN HYDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 431-7047
(423) 979-0569
Mailing address
403 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6034
(423) 431-7047
(423) 979-0569

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
APN0000005082
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5082
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1517566
TN
Enumeration date
10/30/2009
Last updated
02/10/2017
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