Healthcare Provider Details

I. General information

NPI: 1871377192
Provider Name (Legal Business Name): ALEXANDRIA LEIGH YARDLEY DNP, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 ALCOA HWY STE 145
KNOXVILLE TN
37920-1546
US

IV. Provider business mailing address

10118 LONGFORD DR
KNOXVILLE TN
37922-7204
US

V. Phone/Fax

Practice location:
  • Phone: 865-582-3111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number34519
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: