MEDICARE: KNOXVILLE HOPE CLINIC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1154726586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNOXVILLE HOPE CLINIC

Provider Business Mailing 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

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	:	MANAGER
Name	:	AMANDA BENNETT
Credential	:
Telephone Number	:	865-851-8508

Provider Enumeration Date	:	10/28/2014
Last Update Date	:	10/28/2014

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Directions to “KNOXVILLE HOPE CLINIC ” Practice Location

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