Healthcare Provider Details

I. General information

NPI: 1548749831
Provider Name (Legal Business Name): CASSANDRA PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 MEDICAL CENTER WAY
KNOXVILLE TN
37920-3257
US

IV. Provider business mailing address

2101 MEDICAL CENTER WAY
KNOXVILLE TN
37920-3257
US

V. Phone/Fax

Practice location:
  • Phone: 865-546-9221
  • Fax:
Mailing address:
  • Phone: 865-549-5300
  • Fax: 865-594-5833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: