Healthcare Provider Details

I. General information

NPI: 1013984202
Provider Name (Legal Business Name): TERESA JEAN NORWOOD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 GROVE ST
LOUDON TN
37774-1483
US

IV. Provider business mailing address

2236 MISTY RIDGE DR
LENOIR CITY TN
37772-5499
US

V. Phone/Fax

Practice location:
  • Phone: 865-458-9080
  • Fax: 865-458-9096
Mailing address:
  • Phone: 865-988-8876
  • Fax: 865-458-9096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN 5627
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: