Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 16725 | TN |
NPI | 1003161068 |
---|---|
Provider Name | Dawn M Roy |
First Address | Harriman, TN 37748-8709 |
Second Address | Harriman, TN 37748 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 20/10/2018 |