Healthcare Provider Details

I. General information

NPI: 1801496229
Provider Name (Legal Business Name): DONIELLE DAWN BRINKLEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 EDENBRIDGE WAY
KNOXVILLE TN
37923-6615
US

IV. Provider business mailing address

1001 EDENBRIDGE WAY
KNOXVILLE TN
37923-6615
US

V. Phone/Fax

Practice location:
  • Phone: 931-607-1515
  • Fax:
Mailing address:
  • Phone: 931-607-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number166910
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28096
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: