Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 22994 | TN |
NPI | 1003320532 |
---|---|
Provider Name | Lindsay Marie Dyer |
First Address | Knoxville, TN 37923-5010 |
Second Address | Knoxville, TN 37918-1874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2017 |
Last Update Date | 17/03/2018 |