Healthcare Provider Details

I. General information

NPI: 1558241828
Provider Name (Legal Business Name): MERIAH ROSE HEWITT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1338 RUSSELL AVE STE 200
JEFFERSON CITY TN
37760-2761
US

IV. Provider business mailing address

312 PRINCE ST
SEVIERVILLE TN
37862-3823
US

V. Phone/Fax

Practice location:
  • Phone: 865-262-0049
  • Fax: 865-262-0106
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: