Healthcare Provider Details

I. General information

NPI: 1306780960
Provider Name (Legal Business Name): TRADEZHA JEWEL APKINS HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 TEASTER LN STE 111
PIGEON FORGE TN
37863-5274
US

IV. Provider business mailing address

2430 TEASTER LN STE 111
PIGEON FORGE TN
37863-5274
US

V. Phone/Fax

Practice location:
  • Phone: 865-366-1408
  • Fax:
Mailing address:
  • Phone: 865-366-1408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1124
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: