Healthcare Provider Details

I. General information

NPI: 1538139290
Provider Name (Legal Business Name): AMY BOYNTON BEFFREY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY B HUDSON FNP

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4109 PLEASANT RIDGE RD
KNOXVILLE TN
37912-6125
US

IV. Provider business mailing address

4109 PLEASANT RIDGE RD
KNOXVILLE TN
37912-6125
US

V. Phone/Fax

Practice location:
  • Phone: 865-310-7423
  • Fax: 865-637-0454
Mailing address:
  • Phone: 865-310-7423
  • Fax: 865-637-0454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0275911-22
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: