Healthcare Provider Details

I. General information

NPI: 1053225029
Provider Name (Legal Business Name): BRYANNA ADELE THOMAS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 EPPERSON ST
ATHENS TN
37303-3478
US

IV. Provider business mailing address

10732 MERIWETHER LN
KNOXVILLE TN
37934-5287
US

V. Phone/Fax

Practice location:
  • Phone: 423-745-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF09261137
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: