Individual
BRENDA LEE BROOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 NASHVILLE HWY, LEWISBURG, TN 37091-2948
(931) 359-5802
(931) 359-0148
Mailing address
1601 NASHVILLE HWY, LEWISBURG, TN 37091-2948
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000084570
TN
Other
Enumeration date
02/24/2020
Last updated
02/24/2020
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