Individual
MRS. MANDY PROFFITT GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R
Contact information
Practice address
430 COLLEGE ST, NEWPORT, TN 37821-3752
(423) 623-8733
Mailing address
443 BUCKINGHAM DR, NEWPORT, TN 37821-4305
(423) 623-8733
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
110772
TN
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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