Healthcare Provider Details

I. General information

NPI: 1609177211
Provider Name (Legal Business Name): KAREN GOODRICK NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 ALCOA HWY SUITE 145
KNOXVILLE TN
37920-1500
US

IV. Provider business mailing address

1930 ALCOA HWY SUITE 145
KNOXVILLE TN
37920-1500
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-6650
  • Fax:
Mailing address:
  • Phone: 865-305-6650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number6227
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10939607-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: