Individual
JUDITH L DEDEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2650 EXECUTIVE PARK NW, SUITE 5, CLEVELAND, TN 37312-2746
(423) 479-9679
(423) 559-9046
Mailing address
2650 EXECUTIVE PARK NW, SUITE 5, CLEVELAND, TN 37312-2746
(423) 479-9679
(423) 559-9046
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
71050
TN
363L00000X
Nurse Practitioner
16832
TN
Other
Enumeration date
07/11/2012
Last updated
07/19/2012
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