Healthcare Provider Details

I. General information

NPI: 1588084008
Provider Name (Legal Business Name): ROBYN MARLANA BOWLING LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 04/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

626 BERNARD AVE
KNOXVILLE TN
37921-6253
US

IV. Provider business mailing address

626 BERNARD AVE
KNOXVILLE TN
37921-6253
US

V. Phone/Fax

Practice location:
  • Phone: 865-522-0161
  • Fax: 865-521-7920
Mailing address:
  • Phone: 865-522-0161
  • Fax: 865-521-7920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number81612
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: