Individual
MAMIE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
800 S BROWN ST, SPRINGFIELD, TN 37172-2920
(615) 384-4505
Mailing address
800 S BROWN ST, SPRINGFIELD, TN 37172-2920
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
0000174636
TN
Other
Enumeration date
01/18/2018
Last updated
01/18/2018
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