Healthcare Provider Details

I. General information

NPI: 1265214324
Provider Name (Legal Business Name): STEPHANIE LINETTE MERRITT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2023
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7234 TAZEWELL PIKE
CORRYTON TN
37721-3550
US

IV. Provider business mailing address

7234 TAZEWELL PIKE
CORRYTON TN
37721-3550
US

V. Phone/Fax

Practice location:
  • Phone: 865-213-7132
  • Fax:
Mailing address:
  • Phone: 865-213-7132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019005
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number41991
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: