Healthcare Provider Details

I. General information

NPI: 1962727255
Provider Name (Legal Business Name): MAGGIE N. QUINN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAGGIE E NICHOLSON

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 KINGSTON PIKE STE 250
KNOXVILLE TN
37919-3331
US

IV. Provider business mailing address

2607 KINGSTON PIKE STE 250
KNOXVILLE TN
37919-3331
US

V. Phone/Fax

Practice location:
  • Phone: 865-264-2400
  • Fax: 865-588-6406
Mailing address:
  • Phone: 865-264-2400
  • Fax: 865-588-6406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number14861
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number14861
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: