Healthcare Provider Details

I. General information

NPI: 1245644228
Provider Name (Legal Business Name): KRISTEN LYNN PLOETZE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 FORT SANDERS WEST BLVD
KNOXVILLE TN
37922-3355
US

IV. Provider business mailing address

260 FORT SANDERS WEST BLVD
KNOXVILLE TN
37922-3355
US

V. Phone/Fax

Practice location:
  • Phone: 865-558-4400
  • Fax: 865-558-4421
Mailing address:
  • Phone: 865-558-4400
  • Fax: 865-558-4421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2014018118
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number60863
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number01082145A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number60863
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: