Healthcare Provider Details

I. General information

NPI: 1942784921
Provider Name (Legal Business Name): ALLISON MICHELLE RAYMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY
KNOXVILLE TN
37920-1511
US

IV. Provider business mailing address

7708 BUDDING VINE LN
KNOXVILLE TN
37931-1040
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9834
  • Fax:
Mailing address:
  • Phone: 865-805-1563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number182874
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number24435
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number24435
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: