Acne & Rosacea Clinics
Nurse Practitioner, Family in Jackson, TN. Organization (NPI-2).
NPI number1356593545
StatusActive
Last updated in NPPESOct 21, 2008
Details
- NPI
- 1356593545
- Entity type
- Organization (NPI-2)
- Legal business name
- Acne & Rosacea Clinics
- Organization subpart
- No
- Enumeration date
- Oct 21, 2008
- Last updated
- Oct 21, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | APN8135 | TN | Yes |
Practice location
907 Vann Drive Suite MJackson, TN 38305-6046
Phone 731-668-5000 · Fax 731-668-5122
Mailing address
907 Vann Drive Ste MPo Box 11537
Jackson, TN 38012-6046
Phone 731-668-5000 · Fax 731-668-5122
Authorized official
Mary Beth Cox
Owner
7316685000
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