Healthcare Provider Details

I. General information

NPI: 1588506273
Provider Name (Legal Business Name): KATIE MCLAUGHLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE MCQUEEN

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7680 DANNAHER DR
POWELL TN
37849-4052
US

IV. Provider business mailing address

7680 DANNAHER DR
POWELL TN
37849-4052
US

V. Phone/Fax

Practice location:
  • Phone: 865-521-8050
  • Fax: 865-947-7907
Mailing address:
  • Phone: 865-521-8050
  • Fax: 865-947-7907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: