Healthcare Provider Details

I. General information

NPI: 1467931980
Provider Name (Legal Business Name): LINDSAY ANN SAMARIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2018
Last Update Date: 11/18/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4117 E EMORY RD
KNOXVILLE TN
37938-4229
US

IV. Provider business mailing address

1275 DICK LONAS RD UNIT 101
KNOXVILLE TN
37909-1383
US

V. Phone/Fax

Practice location:
  • Phone: 865-922-2121
  • Fax: 833-908-2092
Mailing address:
  • Phone: 865-584-4747
  • Fax: 833-908-0998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number210567
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number24051
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: