Individual
JANELL WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 MCGHEE ST, MARYVILLE, TN 37801-6811
(865) 983-4582
Mailing address
301 MCGHEE ST, MARYVILLE, TN 37801-6811
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
220095
TN
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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