Healthcare Provider Details

I. General information

NPI: 1447166186
Provider Name (Legal Business Name): ELIZABETH PAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5002 CROSSINGS CIR STE 100
MOUNT JULIET TN
37122-8496
US

IV. Provider business mailing address

7804 KARA LN
KNOXVILLE TN
37919-9117
US

V. Phone/Fax

Practice location:
  • Phone: 615-789-1838
  • Fax:
Mailing address:
  • Phone: 865-207-9874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number42798
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: