Healthcare Provider Details

I. General information

NPI: 1194236398
Provider Name (Legal Business Name): MARIA DEL CARMEN RODRIGUEZ-MEZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA DEL CARMEN RODRIGUEZ

II. Dates (important events)

Enumeration Date: 10/16/2017
Last Update Date: 10/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 WESTERN AVE
KNOXVILLE TN
37921-5718
US

IV. Provider business mailing address

6350 W ANDREW JOHNSON HWY DEPT 100
TALBOTT TN
37877-8605
US

V. Phone/Fax

Practice location:
  • Phone: 865-544-0406
  • Fax: 865-544-0480
Mailing address:
  • Phone: 800-355-3565
  • Fax: 423-714-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: