Healthcare Provider Details

I. General information

NPI: 1700475316
Provider Name (Legal Business Name): ASHLEY B WHITE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY B DYKES

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 ALCOA HWY STE 205
KNOXVILLE TN
37920-1504
US

IV. Provider business mailing address

PO BOX 415000-MSC8152
NASHVILLE TN
37241-8152
US

V. Phone/Fax

Practice location:
  • Phone: 865-305-4305
  • Fax: 865-305-4067
Mailing address:
  • Phone: 865-670-6199
  • Fax: 865-670-6198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number28897
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: