Healthcare Provider Details

I. General information

NPI: 1396043790
Provider Name (Legal Business Name): JOANN E KERWIN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2011
Last Update Date: 04/19/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7680 DANNAHER DR
POWELL TN
37849-4052
US

IV. Provider business mailing address

7121 REGAL LANE SUITE 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 NumberA1462
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: