Healthcare Provider Details

I. General information

NPI: 1134525009
Provider Name (Legal Business Name): LAUREN VANNOY JOHNSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 CLINCH AVENUE SUITE 410
KNOXVILLE TN
37916
US

IV. Provider business mailing address

PO BOX 15004
KNOXVILLE TN
37901-5004
US

V. Phone/Fax

Practice location:
  • Phone: 865-343-6976
  • Fax: 877-554-2891
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 Number19356
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: