Healthcare Provider Details

I. General information

NPI: 1215010509
Provider Name (Legal Business Name): TAMARA B BLAND MSN, RN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 LANGLAND ST
KNOXVILLE TN
37915-1415
US

IV. Provider business mailing address

1200 VOLUNTEER BLVD
KNOXVILLE TN
37996-4515
US

V. Phone/Fax

Practice location:
  • Phone: 865-594-5078
  • Fax: 865-594-3921
Mailing address:
  • Phone: 865-594-5078
  • Fax: 865-594-3921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number6885
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: