Healthcare Provider Details

I. General information

NPI: 1942065404
Provider Name (Legal Business Name): TAMMI LYNN HIPSKY NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7307 HINES VALLEY RD
LENOIR CITY TN
37771-8325
US

IV. Provider business mailing address

7307 HINES VALLEY RD
LENOIR CITY TN
37771-8325
US

V. Phone/Fax

Practice location:
  • Phone: 865-748-5402
  • Fax:
Mailing address:
  • Phone: 865-748-5402
  • Fax: 865-748-5402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number00000035161
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number35161
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: