Healthcare Provider Details

I. General information

NPI: 1366559296
Provider Name (Legal Business Name): JAMES ROBERT SANTELLA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DAMERON AVE
KNOXVILLE TN
37917-6413
US

IV. Provider business mailing address

6106 CREEKHEAD DR
KNOXVILLE TN
37909-1009
US

V. Phone/Fax

Practice location:
  • Phone: 865-215-5437
  • Fax: 865-215-5430
Mailing address:
  • Phone: 865-691-0361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000011535
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: