Healthcare Provider Details

I. General information

NPI: 1356165567
Provider Name (Legal Business Name): SARAH ELIZABETH WATERMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY
KNOXVILLE TN
37920-1511
US

IV. Provider business mailing address

122 BELLAS WAY
MARYVILLE TN
37801-4905
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-9834
  • Fax:
Mailing address:
  • Phone: 865-300-9783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number37670
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: