MEDICARE: CRYSTAL F WHEELON APN

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	7023	TN

General Provider Information

NPI Number	:	1831282680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL F WHEELON APN

Provider Business Mailing Address
First Line	:	PO BOX 440251
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37244-0251
Country	:	US
Telephone Number	:	865-670-6199
Fax Number	:	865-670-6158

Provider Business Practice Location Address
First Line	:	1934 ALCOA HWY
Second Line	:	STE 476
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-1524
Country	:	US
Telephone Number	:	865-544-9218
Fax Number	:	865-544-8262

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	11/14/2008

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Directions to “ CRYSTAL F WHEELON APN” Practice Location

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