Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | F02210836 | TN |
NPI | 1467046789 |
---|---|
Provider Name | John Pound |
First Address | Chattanooga, TN 37405-3533 |
Second Address | Chattanooga, TN 37403-2163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2021 |
Last Update Date | 26/02/2021 |