Healthcare Provider Details

I. General information

NPI: 1497872733
Provider Name (Legal Business Name): AMANDA PERRY N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 W CLINCH AVE
KNOXVILLE TN
37916-2203
US

IV. Provider business mailing address

2201 W CLINCH AVE
KNOXVILLE TN
37916-2203
US

V. Phone/Fax

Practice location:
  • Phone: 865-525-0228
  • Fax: 865-525-0285
Mailing address:
  • Phone: 865-525-0228
  • Fax: 865-525-0285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8447
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: