Healthcare Provider Details

I. General information

NPI: 1275907685
Provider Name (Legal Business Name): ERIK TAYLOR FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 W CLINCH AVE SUITE 200
KNOXVILLE TN
37916-2434
US

IV. Provider business mailing address

PO BOX 52948
KNOXVILLE TN
37950-2948
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-3695
  • Fax: 865-602-3528
Mailing address:
  • Phone: 865-306-5675
  • Fax: 865-584-7712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20153
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: