Healthcare Provider Details

I. General information

NPI: 1972865632
Provider Name (Legal Business Name): NELYE JOSIANE DJOUWE KENGNE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10745 KINGSTON PIKE
KNOXVILLE TN
37934-3002
US

IV. Provider business mailing address

10745 KINGSTON PIKE
KNOXVILLE TN
37934-3002
US

V. Phone/Fax

Practice location:
  • Phone: 865-218-7711
  • Fax:
Mailing address:
  • Phone: 865-218-7711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000042653
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: