Healthcare Provider Details

I. General information

NPI: 1538104617
Provider Name (Legal Business Name): HEENA PATEL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1934 ALCOA HWY STE 285
KNOXVILLE TN
37920-1528
US

IV. Provider business mailing address

1934 ALCOA HWY STE 285
KNOXVILLE TN
37920-1528
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9620
  • Fax: 865-525-3460
Mailing address:
  • Phone: 865-305-9620
  • Fax: 865-525-3460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8117
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: