Healthcare Provider Details

I. General information

NPI: 1023268638
Provider Name (Legal Business Name): CHRISTY BROOKE BOTTOMS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 E EMERALD AVE STE 614
KNOXVILLE TN
37917
US

IV. Provider business mailing address

930 E EMERALD AVE STE 614
KNOXVILLE TN
37917-4555
US

V. Phone/Fax

Practice location:
  • Phone: 865-647-3920
  • Fax: 865-647-3929
Mailing address:
  • Phone: 865-647-3920
  • Fax: 865-647-3929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number13519
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: