Individual
ANDREA SOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
920 UNIVERSITY ST, MARTIN, TN 38237-1605
(731) 588-5829
Mailing address
920 UNIVERSITY ST, MARTIN, TN 38237-1605
(901) 819-7872
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
25042
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25042
LICENSE
TN
Enumeration date
07/14/2016
Last updated
07/14/2016
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