Individual
MRS. COURTNEY PAIGE PENDERGRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-4000
(423) 224-5120
Mailing address
PO BOX 11724, KNOXVILLE, TN 37939-1724
(865) 766-8800
(865) 766-8874
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024169574
VA
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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