Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 21920 | TN |
NPI | 1003367517 |
---|---|
Provider Name | Charity Helton |
First Address | Unicoi, TN 37692-6840 |
Second Address | Johnson City, TN 37604-6035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2016 |
Last Update Date | 02/04/2019 |