Healthcare Provider Details

I. General information

NPI: 1194691865
Provider Name (Legal Business Name): TONYA M NICHOLS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 SHERWAY RD STE 2
KNOXVILLE TN
37922-2224
US

IV. Provider business mailing address

6926 WASHINGTON PIKE
KNOXVILLE TN
37918-7128
US

V. Phone/Fax

Practice location:
  • Phone: 865-333-4554
  • Fax: 865-298-8150
Mailing address:
  • Phone: 865-333-4554
  • Fax: 865-298-8150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: