Healthcare Provider Details

I. General information

NPI: 1689611030
Provider Name (Legal Business Name): TERRI L CRABTREE F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 GROVE ST
LOUDON TN
37774-1575
US

IV. Provider business mailing address

PO BOX 5777
MARYVILLE TN
37802-5777
US

V. Phone/Fax

Practice location:
  • Phone: 865-980-5200
  • Fax: 865-246-2106
Mailing address:
  • Phone: 865-246-2104
  • Fax: 865-246-2106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11651
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: