Healthcare Provider Details

I. General information

NPI: 1437837697
Provider Name (Legal Business Name): BRENDA SVOBODA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 20TH ST STE 505
KNOXVILLE TN
37916-1869
US

IV. Provider business mailing address

501 20TH ST STE 505
KNOXVILLE TN
37916-1869
US

V. Phone/Fax

Practice location:
  • Phone: 865-546-0157
  • Fax: 865-374-2177
Mailing address:
  • Phone: 865-546-0157
  • Fax: 865-374-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number34117
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: