Healthcare Provider Details

I. General information

NPI: 1053108399
Provider Name (Legal Business Name): MONICA LYNN PRATER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA LYNN MOYERS

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2212 JACKSBORO PIKE
LA FOLLETTE TN
37766-2903
US

IV. Provider business mailing address

PO BOX 26194
BELFAST ME
04915-2012
US

V. Phone/Fax

Practice location:
  • Phone: 423-566-8181
  • Fax: 833-908-2077
Mailing address:
  • Phone: 865-584-4747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number38790
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: