Healthcare Provider Details

I. General information

NPI: 1407557226
Provider Name (Legal Business Name): HOPE RUSSELL SOREY AG-ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY
KNOXVILLE TN
37920-1511
US

IV. Provider business mailing address

5125 MOUNTAINCREST DR
KNOXVILLE TN
37918-4520
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9000
  • Fax:
Mailing address:
  • Phone: 601-813-5993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number252703
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number33744
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: