Healthcare Provider Details

I. General information

NPI: 1255968772
Provider Name (Legal Business Name): PRIANCA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 PINNACLE POINTE WAY
KNOXVILLE TN
37922-6702
US

IV. Provider business mailing address

1930 PINNACLE POINTE WAY
KNOXVILLE TN
37922-6702
US

V. Phone/Fax

Practice location:
  • Phone: 865-474-8800
  • Fax:
Mailing address:
  • Phone: 865-474-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5581
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: