Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 34701 | AZ |
NPI | 1285603316 |
---|---|
Provider Name | Dr. Allison Patricia Puckett |
First Address | Nashville, TN 37228 |
Second Address | Murfreesboro, TN 37129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 25/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I22006 | (02) | AZ |