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Individual

KATRINA MARIE RIVERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
430 TIPPAH ST S, GRAND JUNCTION, TN 38039-4423
(901) 896-5333
Mailing address
430 TIPPAH ST S, GRAND JUNCTION, TN 38039-4423
(901) 896-5333

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0000072874
TN

Other

Enumeration date
08/14/2012
Last updated
08/14/2012
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