Healthcare Provider Details

I. General information

NPI: 1174771661
Provider Name (Legal Business Name): RHONDA SUTHERLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 BAUM DR BUILDING 2
KNOXVILLE TN
37919-7315
US

IV. Provider business mailing address

6800 BAUM DR BUILDING 1
KNOXVILLE TN
37919-7315
US

V. Phone/Fax

Practice location:
  • Phone: 865-374-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number167188
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: