Healthcare Provider Details

I. General information

NPI: 1275151557
Provider Name (Legal Business Name): ASHLEY L HAUN CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CLINCH AVENUE
KNOXVILLE TN
37916
US

IV. Provider business mailing address

2201 CLINCH AVENUE
KNOXVILLE TN
37916
US

V. Phone/Fax

Practice location:
  • Phone: 865-525-0228
  • Fax: 865-525-0285
Mailing address:
  • Phone: 865-525-0228
  • Fax: 865-525-0285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number167509
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number0000167509
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29791
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: