Healthcare Provider Details

I. General information

NPI: 1568417111
Provider Name (Legal Business Name): SWEETIE SANGEETA KRISHEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4233 HIGHWAY 411
MADISONVILLE TN
37354-1571
US

IV. Provider business mailing address

119 EPPERSON ST
ATHENS TN
37303-3478
US

V. Phone/Fax

Practice location:
  • Phone: 423-545-8383
  • Fax: 423-545-8387
Mailing address:
  • Phone: 423-745-7500
  • Fax: 423-745-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.022295
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD55274
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: