Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 2144 | TN |
NPI | 1487678835 |
---|---|
Provider Name | Dr. Nikkalynn F Delaurentis |
First Address | Clarksville, TN 37043-8039 |
Second Address | Clarksville, TN 37043-8039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 09/12/2015 |