Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 30526 | TN |
NPI | 1053072637 |
---|---|
Provider Name | Karen Parham |
First Address | Pleasant View, TN 37146 |
Second Address | Pleasant View, TN 37146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2022 |
Last Update Date | 05/01/2022 |