Healthcare Provider Details

I. General information

NPI: 1871420091
Provider Name (Legal Business Name): EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 22ND ST
KNOXVILLE TN
37916-2211
US

IV. Provider business mailing address

PO BOX 15004
KNOXVILLE TN
37901-5004
US

V. Phone/Fax

Practice location:
  • Phone: 865-637-1346
  • Fax:
Mailing address:
  • Phone: 865-541-8895
  • Fax: 865-633-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW ROSENDAHL
Title or Position: CFO
Credential:
Phone: 612-237-4353