Healthcare Provider Details

I. General information

NPI: 1043342785
Provider Name (Legal Business Name): CHRISTY M MONROE LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTY M DAILEY LPN

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 SIMMONS ST
MARYVILLE TN
37801-4750
US

IV. Provider business mailing address

2416 SOUTHVIEW DR
MARYVILLE TN
37803-6635
US

V. Phone/Fax

Practice location:
  • Phone: 865-374-7100
  • Fax:
Mailing address:
  • Phone: 865-684-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number61265
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number0000061265
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: