Organization · Type 2 NPI
East Tennessee State University
Primary Care Nurse Practitioner · Gray, TN
NPI number
1033344007
Active
Practice location
1440 Suncrest Dr
Gray, TN 37615-4118
Fax (423) 477-1625
Mailing address
365 Stout Drive Box 70403
Johnson City, TN 37614-1703
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | None listed |
Primary Care Nurse Practitioner: Definition to come...
2 other providers at this address
About NPI 1033344007
East Tennessee State University's National Provider Identifier is 1033344007, issued on May 20, 2009. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Gray, TN. The record was last updated on Feb 23, 2017.