is a Nurse Practitioner in Johnson City, Tennessee. practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for is 1154432003. The last update date is .
's current location address is 1021 W Oakland Ave Ste 310, Johnson City, Tennessee. You can contact this provider via phone number 4233026565. The mailing address for is 1021 W Oakland Ave Ste 310, Johnson City, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1021 W Oakland Ave Ste 310, Johnson City, Tennessee |
| Phone Number | 4233026565 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1154432003 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1021 W Oakland Ave Ste 310 |
|---|---|
| City | Johnson City |
| State | Tennessee (TN) |
| Post Code | 376042192 |
| Phone Number | 4233026565 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 5010643 |
|
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 425076205 | MO | -- |
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