Healthcare Provider Details

I. General information

NPI: 1750773289
Provider Name (Legal Business Name): HOLLY PARKISON JUSTICE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY MELISSA PARKISON FNP

II. Dates (important events)

Enumeration Date: 02/20/2015
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY
KNOXVILLE TN
37920-1511
US

IV. Provider business mailing address

415 BROAD ST SUITE 410
KINGSPORT TN
37660-4263
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9402
  • Fax:
Mailing address:
  • Phone: 423-239-9737
  • Fax: 423-389-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN0000194224
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number19608
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number19608
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: