Healthcare Provider Details

I. General information

NPI: 1083745459
Provider Name (Legal Business Name): MARY J CATHEY CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 CLINCH AVENUE SUITE 210
KNOXVILLE TN
37916
US

IV. Provider business mailing address

PO BOX 15004
KNOXVILLE TN
37901-5004
US

V. Phone/Fax

Practice location:
  • Phone: 865-523-5437
  • Fax: 865-541-8675
Mailing address:
  • Phone: 865-541-8895
  • Fax: 865-633-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number8348
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: