Healthcare Provider Details

I. General information

NPI: 1821260803
Provider Name (Legal Business Name): STEPHANIE LYNN TIPTON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2008
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9957 SHERRILL BLVD
KNOXVILLE TN
37932-3366
US

IV. Provider business mailing address

6016 BROOKVALE LANE, STE 200
KNOXVILLE TN
37919-4003
US

V. Phone/Fax

Practice location:
  • Phone: 865-693-2255
  • Fax: 865-691-7888
Mailing address:
  • Phone: 865-862-0998
  • Fax: 865-544-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number145233
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13218
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: