Healthcare Provider Details
I. General information
NPI: 1457470015
Provider Name (Legal Business Name): KAREN PHILLIPS BEETS F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/28/2007
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7701 CORRYTON RD
CORRYTON TN
37721-2630
US
IV. Provider business mailing address
PO BOX 565
MAYNARDVILLE TN
37807-0565
US
V. Phone/Fax
- Phone: 865-247-6263
- Fax: 865-992-8103
- Phone: 865-992-3031
- Fax: 865-992-8103
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 0000006290 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: