Healthcare Provider Details

I. General information

NPI: 1922864685
Provider Name (Legal Business Name): SHANTELLE LACRESHA STOKELY APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 E ANDREW JOHNSON HWY STE 2
GREENEVILLE TN
37745-5826
US

IV. Provider business mailing address

6016 BROOKVALE LN STE 200
KNOXVILLE TN
37919-4092
US

V. Phone/Fax

Practice location:
  • Phone: 423-639-0243
  • Fax: 423-639-0628
Mailing address:
  • Phone: 865-862-0998
  • Fax: 865-544-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number41945
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: