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Individual

CHRISTA ST. JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1101 NEAL ST, COOKEVILLE, TN 38501-0901
(931) 528-8593
Mailing address
284 PEA RIDGE RD, ELMWOOD, TN 38560-4208
(615) 417-2207

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
53760
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
53760
LPN LICENSE
TN
Enumeration date
01/22/2013
Last updated
01/22/2013
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