Individual
ASHA P SPROLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 MEDICAL PARK BLVD FL 5, BRISTOL, TN 37620-7430
(423) 844-6000
(423) 844-6027
Mailing address
509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
(423) 302-6567
(423) 952-2175
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
194780
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024179054
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
27375
TN
Other
Enumeration date
02/18/2020
Last updated
06/10/2020
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