Healthcare Provider Details

I. General information

NPI: 1396735288
Provider Name (Legal Business Name): DENISE ANN ANDERSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 LAKE BROOK BLVD STE 101
KNOXVILLE TN
37909-3761
US

IV. Provider business mailing address

3001 LAKE BROOK BLVD STE 101
KNOXVILLE TN
37909-3761
US

V. Phone/Fax

Practice location:
  • Phone: 865-374-0600
  • Fax:
Mailing address:
  • Phone: 865-374-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number431
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number431-033
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number35681
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: