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Individual

WENDELL C. SOARES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
330 PAGEANT LN, CLARKSVILLE, TN 37040-3854
(931) 648-5747
(931) 645-9019
Mailing address
330 PAGEANT LN, CLARKSVILLE, TN 37040-3854
(931) 648-5747
(931) 645-9019

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
154726
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
154726
RN
TN
Enumeration date
04/11/2007
Last updated
07/08/2007
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