Healthcare Provider Details

I. General information

NPI: 1518108596
Provider Name (Legal Business Name): RACHEL TAYLOR CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TECH CENTER DR
KNOXVILLE TN
37912-2728
US

IV. Provider business mailing address

100 TECH CENTER DR
KNOXVILLE TN
37912-2728
US

V. Phone/Fax

Practice location:
  • Phone: 865-687-2000
  • Fax: 865-687-6775
Mailing address:
  • Phone: 865-687-2000
  • Fax: 865-687-6775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number14082
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number163726
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: