Healthcare Provider Details

I. General information

NPI: 1619016573
Provider Name (Legal Business Name): ERICA NICOLE ENSEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA NICOLE GREENE FNP-BC

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 N. CHANCERY ST. ALLERGY, ASTHMA AND SINUS CENTER
MCMINNVILLE TN
37110-2048
US

IV. Provider business mailing address

6701 BAUM DR STE 140 THE ALLERGY, ASTHMA & SINUS CENTER
KNOXVILLE TN
37919-7361
US

V. Phone/Fax

Practice location:
  • Phone: 931-474-7000
  • Fax: 931-474-7040
Mailing address:
  • Phone: 865-584-5727
  • Fax: 865-450-9904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number12559
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000150020
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: