Healthcare Provider Details

I. General information

NPI: 1740291855
Provider Name (Legal Business Name): NADINE M TRAINER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 CHILDRENS WAY
KNOXVILLE TN
37922
US

IV. Provider business mailing address

PO BOX 15004
KNOXVILLE TN
37901
US

V. Phone/Fax

Practice location:
  • Phone: 865-690-5006
  • Fax: 865-690-2625
Mailing address:
  • Phone: 865-541-8895
  • Fax: 865-633-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number24709
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: