Individual
TAMMY MICHELLE WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3575 KEITH ST NW, CLEVELAND, TN 37312-4324
(142) 345-8666
Mailing address
3575 KEITH ST NW, CLEVELAND, TN 37312-4324
(423) 458-6660
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0000085839
TN
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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