| Organization Name: | LAFOLLETTE WELLNESS CENTER |
| NPI Number: | 1457696502 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARON M NAYLOR (NURSE PRACTITIONER/OWNER) |
| Mailing Address: | 2212 Jacksboro Pike La Follette |
| State: | TN US |
| Postal Code: | 377662903 |
| Phone Number: | 4232019287 |
| Fax Number: | 4232019290 |
| NPI Enumeration Date: | 11/30/2012 |
| NPI Last Update Date: | 11/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 13338 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |