Healthcare Provider Details

I. General information

NPI: 1336920461
Provider Name (Legal Business Name): ROZINA BOATWRIGHT REGISTERED NURSES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2023
Last Update Date: 10/13/2023
Certification Date: 10/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 MERCHANTS CENTER BLVD
KNOXVILLE TN
37912-3470
US

IV. Provider business mailing address

200 TECH CENTER DR
KNOXVILLE TN
37912-2747
US

V. Phone/Fax

Practice location:
  • Phone: 865-282-9533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number0000200939
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: