Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 14057 | TN |
NPI | 1588807523 |
---|---|
Provider Name | Mrs. Vicki F. Cannington |
First Address | Nashville, TN 37244-0504 |
Second Address | Knoxville, TN 37920-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2009 |
Last Update Date | 15/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1514046 | (05) | TN |