Healthcare Provider Details

I. General information

NPI: 1487325171
Provider Name (Legal Business Name): MARALINE ELIZABETH FERRIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9303 PARK WEST BLVD STE 100
KNOXVILLE TN
37923-4304
US

IV. Provider business mailing address

9303 PARK WEST BLVD STE 100
KNOXVILLE TN
37923-4304
US

V. Phone/Fax

Practice location:
  • Phone: 781-278-5540
  • Fax:
Mailing address:
  • Phone: 865-951-0083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA8371
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: