MEDICARE: PALMSUP BEHAVIORAL HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1063376242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMSUP BEHAVIORAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	4869 CHAMBLISS AVE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-5122
Country	:	US
Telephone Number	:	865-217-0810
Fax Number	:	865-270-4520

Provider Business Practice Location Address
First Line	:	4869 CHAMBLISS AVE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-5122
Country	:	US
Telephone Number	:	865-217-0810
Fax Number	:	865-270-4520

Authorized Official
Title or Position	:	PSYCHIATRIC MENTAL HEALTH NP
Name	:	AMY PALMER
Credential	:	PMHNP
Telephone Number	:	865-217-0810

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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