Individual
MRS. BLAIR QUESENBERRY JERVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
809 LAMONT STREET, MOUNTAIN HOME, TN 37684
(723) 926-1171
Mailing address
PO BOX 4000, MOUNTAIN HOME, TN 37684-4000
(423) 926-1171
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0000212582
TN
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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