Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APN0000008438 | TN |
NPI | 1023147766 |
---|---|
Provider Name | Joan Cornelia Mccuen |
First Address | Oregon City, OR 97045 |
Second Address | Nashville, TN 37212-4929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 18/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4087312 | BCBS PROVIDER ID (01) | TN |