Healthcare Provider Details

I. General information

NPI: 1710989215
Provider Name (Legal Business Name): PAULA R MACMORRAN PH.D., APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 06/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N WEISGARBER RD
KNOXVILLE TN
37919-4013
US

IV. Provider business mailing address

201 N WEISGARBER RD
KNOXVILLE TN
37919-4013
US

V. Phone/Fax

Practice location:
  • Phone: 865-584-8501
  • Fax: 865-588-1219
Mailing address:
  • Phone: 865-584-8501
  • Fax: 865-588-1219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberP-1271
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberAPRN-5128
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: