Healthcare Provider Details

I. General information

NPI: 1356898001
Provider Name (Legal Business Name): TASHA LIGON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4016 PEAKS LANDING WAY APT 103
KNOXVILLE TN
37918-7934
US

IV. Provider business mailing address

4016 PEAKS LANDING WAY APT 103
KNOXVILLE TN
37918-7934
US

V. Phone/Fax

Practice location:
  • Phone: 865-237-8033
  • Fax:
Mailing address:
  • Phone: 865-237-8033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberX9R5D7L5
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: