Individual
MRS. JANE E FARIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3810
(423) 224-5631
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN5872
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3908886
—
TN
Enumeration date
06/29/2006
Last updated
07/20/2012
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