Healthcare Provider Details

I. General information

NPI: 1528731502
Provider Name (Legal Business Name): NATASHA ALEXIA RICHESIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 W MADISON AVE STE 1
ATHENS TN
37303-3496
US

IV. Provider business mailing address

1275 DICK LONAS RD UNIT 101
KNOXVILLE TN
37909-1383
US

V. Phone/Fax

Practice location:
  • Phone: 423-745-6575
  • Fax: 833-916-2416
Mailing address:
  • Phone: 865-584-4747
  • Fax: 865-584-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number4678
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: