Healthcare Provider Details

I. General information

NPI: 1184628612
Provider Name (Legal Business Name): MELISSA A ROBBINS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 04/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2428 KNOB CREEK RD SUITE 102
JOHNSON CITY TN
37604-2397
US

IV. Provider business mailing address

6701 BAUM DR SUITE 140
KNOXVILLE TN
37919-7360
US

V. Phone/Fax

Practice location:
  • Phone: 423-794-1074
  • Fax: 423-794-1079
Mailing address:
  • Phone: 865-584-5727
  • Fax: 865-450-9904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN7933
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: