Healthcare Provider Details
I. General information
NPI: 1396014643
Provider Name (Legal Business Name): KASEY ELIZABETH KOHRING WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/15/2011
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11039 PARKSIDE DR
KNOXVILLE TN
37934-1953
US
IV. Provider business mailing address
1433 W WOODSHIRE DR
KNOXVILLE TN
37922-5642
US
V. Phone/Fax
- Phone: 865-392-1388
- Fax: 865-392-1391
- Phone: 615-429-4896
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | 22808 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | RN233062 |
| License Number State | GA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | 0024169785 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: