Healthcare Provider Details

I. General information

NPI: 1831085372
Provider Name (Legal Business Name): JOHN EVAN ACOSTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER COLLEGE OF NURSING, 874 UNION AVENUE, RM 325
MEMPHIS TN
38163
US

IV. Provider business mailing address

UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER COLLEGE OF NURSING, 874 UNION AVENUE, RM 325
MEMPHIS TN
38163
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-6128
  • Fax:
Mailing address:
  • Phone: 901-448-6128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: