Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 18992 | TN |
NPI | 1003224155 |
---|---|
Provider Name | Janice Callahan |
First Address | Franklin, TN 37067-6444 |
Second Address | Franklin, TN 37067-6445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2014 |
Last Update Date | 31/07/2014 |