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Individual

MARY K ELWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
228 N MAIN ST, SUITE 2, GREENEVILLE, TN 37745-5033
(423) 639-2161
Mailing address
1225 E WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10472
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00391974
RR MEDICARE PIN
TN
Enumeration date
10/02/2006
Last updated
05/02/2008
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