Healthcare Provider Details

I. General information

NPI: 1962827428
Provider Name (Legal Business Name): AMY SEXTON HARRELL MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2014
Last Update Date: 05/22/2023
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7331 TAZEWELL PIKE
CORRYTON TN
37721-3516
US

IV. Provider business mailing address

7331 TAZEWELL PIKE
CORRYTON TN
37721-3516
US

V. Phone/Fax

Practice location:
  • Phone: 865-249-8044
  • Fax: 865-985-0756
Mailing address:
  • Phone: 865-249-8044
  • Fax: 865-985-0756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18444
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: