Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 19142 | TN |
N | 111NI0900X | Internist | 19142 | TN |
N | 207RA0401X | Internist - Addiction Medicine | 19142 | TN |
NPI | 1770607665 |
---|---|
Provider Name | Christine Kasser |
First Address | Cordova, TN 38018-7283 |
Second Address | Cordova, TN 38018-7283 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A64514 | (02) | TN |