Healthcare Provider Details
I. General information
NPI: 1962775403
Provider Name (Legal Business Name): JENNIFER KRISTEN PHILLIPS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/14/2012
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2018 WESTERN AVE
KNOXVILLE TN
37921-5718
US
IV. Provider business mailing address
1923 SULPHUR SPRINGS RD
MORRISTOWN TN
37813-5654
US
V. Phone/Fax
- Phone: 865-544-0406
- Fax: 865-544-0480
- Phone: 423-317-9344
- Fax: 423-714-2355
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 16387 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: