Healthcare Provider Details

I. General information

NPI: 1013761212
Provider Name (Legal Business Name): ABIGAIL LEA ARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1926 ALCOA HWY STE 410
KNOXVILLE TN
37920-1545
US

IV. Provider business mailing address

PO BOX 415000-MSC8129
NASHVILLE TN
37241-0001
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9000
  • Fax:
Mailing address:
  • Phone: 229-669-5325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: