MEDICARE: EMILY SHANKS

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	374J00000X	Doula		TN

General Provider Information

NPI Number	:	1366305245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY SHANKS

Provider Business Mailing Address
First Line	:	4305 RARE EARTH DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37938-2984
Country	:	US
Telephone Number	:	865-235-5288
Fax Number	:

Provider Business Practice Location Address
First Line	:	5344 N BROADWAY ST
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-3266
Country	:	US
Telephone Number	:	865-370-3433
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ EMILY SHANKS ” Practice Location

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