Healthcare Provider Details

I. General information

NPI: 1295303972
Provider Name (Legal Business Name): KRISTIE H STEVENS AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIE HELENA ROBERTS AUD

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 07/26/2024
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GREATER KNOXVILLE EAR NOSE AND THROAT ASSOCIATES, PC. 7680 DANNAHER DR.
POWELL TN
37849-4052
US

IV. Provider business mailing address

GREATER KNOXVILLE EAR NOSE AND THROAT ASSOCIATES, PC. 7121 REGAL LN STE 200A
KNOXVILLE TN
37918-5804
US

V. Phone/Fax

Practice location:
  • Phone: 865-521-8050
  • Fax: 865-544-5816
Mailing address:
  • Phone: 865-521-8050
  • Fax: 865-544-5816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA2233
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number271461
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: