Healthcare Provider Details

I. General information

NPI: 1598174609
Provider Name (Legal Business Name): PAMELA WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 STONEHAVEN DR
KNOXVILLE TN
37938-3835
US

IV. Provider business mailing address

1800 STONEHAVEN DR
KNOXVILLE TN
37938-3835
US

V. Phone/Fax

Practice location:
  • Phone: 865-255-7230
  • Fax:
Mailing address:
  • Phone: 865-255-7230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374K00000X
TaxonomyReligious Nonmedical Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: