Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 25707 | TN |
NPI | 1013569201 |
---|---|
Provider Name | Sarah Gail Lord |
First Address | Morristown, TN 37813-5654 |
Second Address | Knoxville, TN 37921-5718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2019 |
Last Update Date | 29/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ML5301609 | DEA (01) | TN |