Healthcare Provider Details

I. General information

NPI: 1376849927
Provider Name (Legal Business Name): ANGELIA RABY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2011
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W SPRINGDALE AVE
KNOXVILLE TN
37917-5158
US

IV. Provider business mailing address

2832 MOSSY OAKS LN
KNOXVILLE TN
37921-7704
US

V. Phone/Fax

Practice location:
  • Phone: 865-637-9711
  • Fax:
Mailing address:
  • Phone: 865-296-8075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN0000160265
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License NumberRN0000160265
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN0000160265
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000160265
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: