Healthcare Provider Details

I. General information

NPI: 1659669497
Provider Name (Legal Business Name): CARRIE PATRICIA FREIRE-BOZEMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 07/26/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 E WEISGARBER RD STE 100
KNOXVILLE TN
37909-2677
US

IV. Provider business mailing address

1128 E WEISGARBER RD STE 100
KNOXVILLE TN
37909-2677
US

V. Phone/Fax

Practice location:
  • Phone: 865-579-0552
  • Fax: 865-934-2680
Mailing address:
  • Phone: 865-579-0552
  • Fax: 865-541-1003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number15945
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: