Organization
MT VIEW FAMILY CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LAWANA L MCKISSACK (CREDENTIALING SPECIALIST)
(615) 482-4879
Entity
Organization
Contact information
Practice address
10541 CEDAR GROVE RD, STE. 130, SMYRNA, TN 37167-8123
(615) 727-2434
Mailing address
10541 CEDAR GROVE RD, STE. 130, SMYRNA, TN 37167-8123
(615) 727-2434
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
15063
TN
Other
Enumeration date
09/04/2013
Last updated
09/04/2013
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