Individual
HEIDI NICOLE DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
929 CRESCENT ST, JEFFERSON CITY, TN 37760-3644
(828) 206-0020
Mailing address
929 CRESCENT ST, JEFFERSON CITY, TN 37760-3644
(828) 206-0020
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
206521
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
62611
NM
Other
Enumeration date
10/04/2020
Last updated
04/02/2021
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