Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APN0000010776 | TN |
NPI | 1023116605 |
---|---|
Provider Name | Melissa Lynn Vance |
First Address | Stilwell, KS 66085-0512 |
Second Address | Nashville, TN 37205-2005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 12/03/2020 |