Healthcare Provider Details

I. General information

NPI: 1265174965
Provider Name (Legal Business Name): MARGARET LUPER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY
KNOXVILLE TN
37920-1511
US

IV. Provider business mailing address

2612 SAINT JAMES AVE
KNOXVILLE TN
37920-3637
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9830
  • Fax:
Mailing address:
  • Phone: 865-567-7523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number31133
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: