Individual
MARTHA JOAN HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
804 N PARKWAY, JACKSON, TN 38305-3058
(731) 423-3020
Mailing address
17 HWY 152, P O BOX 72, SPRING CREEK, TN 38378
(731) 695-4248
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000015271
TN
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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