Individual
JUANJECA QUIYATTA BARROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
52 PEMBERTON CV, JACKSON, TN 38305-5514
(731) 234-5663
Mailing address
52 PEMBERTON CV, JACKSON, TN 38305-5514
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN230487
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
28371
SC
Other
Enumeration date
05/25/2022
Last updated
02/27/2024
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