MEDICARE: BRITTANY HARTGROVE FNP

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	363LF0000X	Family Nurse Practitioner	18742	TN

General Provider Information

NPI Number	:	1114330321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY HARTGROVE FNP

Provider Business Mailing Address
First Line	:	10750 GARDEN CROSSING WAY
Second Line	:	APT 301
City	:	KNOXVILLE
State	:	TN
Zip	:	37932-3751
Country	:	US
Telephone Number	:	865-851-8508
Fax Number	:	865-851-8097

Provider Business Practice Location Address
First Line	:	900 W BAXTER AVE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37921-6851
Country	:	US
Telephone Number	:	865-851-8508
Fax Number	:	865-851-8097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	11/01/2016

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