Healthcare Provider Details
I. General information
NPI: 1245015718
Provider Name (Legal Business Name): HEATHER SILCOX PORTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/31/2023
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6348 LONAS SPRING DR
KNOXVILLE TN
37909-2719
US
IV. Provider business mailing address
6348 LONAS SPRING DR
KNOXVILLE TN
37909-2719
US
V. Phone/Fax
- Phone: 865-337-5137
- Fax: 888-839-6922
- Phone: 865-337-5137
- Fax: 888-839-6922
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 34746 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: