Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 20129 | TN |
NPI | 1003290826 |
---|---|
Provider Name | Mrs. Sarah Michelle Wredling |
First Address | Memphis, TN 38122-5225 |
Second Address | Memphis, TN 38122-5225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2015 |
Last Update Date | 19/08/2019 |