EAST TENNESSEE STATE UNIVERSITY

NPI # 

Practice Address:

1000 N Roan St

Johnson City, TN, 37601-4616

Practice Phone:

423-434-5249

Practice Fax:

423-434-5295

Taxonomy Grouping:

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy Classification:

Nurse Practitioner

Taxonomy Specialization:

Family

Taxonomy Code:

363LF0000X