Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD000045213 | TN |
NPI | 1013127430 |
---|---|
Provider Name | Annette Marie Abril |
First Address | Kingsport, TN 37660-7390 |
Second Address | Kingsport, TN 37660-7390 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 03/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1031661492 | PTAN (01) | TN |