Healthcare Provider Details

I. General information

NPI: 1407065071
Provider Name (Legal Business Name): JEANNE MARGARET HASTINGS MS, CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 ASHEVILLE HWY
KNOXVILLE TN
37924-4500
US

IV. Provider business mailing address

5104 PEARL VALLEY RD
SEVIERVILLE TN
37876-6827
US

V. Phone/Fax

Practice location:
  • Phone: 865-654-9207
  • Fax: 865-933-6323
Mailing address:
  • Phone: 865-774-9334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: