Healthcare Provider Details

I. General information

NPI: 1245056159
Provider Name (Legal Business Name): HUGH FRIAR RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY
KNOXVILLE TN
37920-1511
US

IV. Provider business mailing address

PO BOX 864
KODAK TN
37764-0864
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number224380
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number224380
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: