Healthcare Provider Details

I. General information

NPI: 1588383046
Provider Name (Legal Business Name): KRISTEN KOWALSKI DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6108 KINGSTON PIKE
KNOXVILLE TN
37919-4019
US

IV. Provider business mailing address

1025 PEERLESS XING NW
CLEVELAND TN
37312-3764
US

V. Phone/Fax

Practice location:
  • Phone: 865-539-9299
  • Fax: 423-476-5887
Mailing address:
  • Phone: 423-476-5990
  • Fax: 423-476-5887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33661
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: