Healthcare Provider Details

I. General information

NPI: 1255236287
Provider Name (Legal Business Name): CREEKWORTH PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11909 KINGSTON PIKE STE 201
KNOXVILLE TN
37934-4878
US

IV. Provider business mailing address

116 AGNES RD STE 200
KNOXVILLE TN
37919-6306
US

V. Phone/Fax

Practice location:
  • Phone: 865-874-3417
  • Fax:
Mailing address:
  • Phone: 865-874-3417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: AMANDA ALBERTSEN
Title or Position: MEMBER
Credential: APRN, PMHNP-BC
Phone: 865-874-3417