Healthcare Provider Details

I. General information

NPI: 1104891852
Provider Name (Legal Business Name): SONIA TINDELL CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 06/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8861 KINGSTON PIKE
KNOXVILLE TN
37923
US

IV. Provider business mailing address

8861 KINGSTON PIKE
KNOXVILLE TN
37923
US

V. Phone/Fax

Practice location:
  • Phone: 865-357-8861
  • Fax: 865-357-8866
Mailing address:
  • Phone: 865-357-8861
  • Fax: 865-357-8866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN0000010916
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN0000010916
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: