Healthcare Provider Details

I. General information

NPI: 1700475498
Provider Name (Legal Business Name): LINDSEY JO CHERNICKY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2021
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7557 DANNAHER DR STE G20
POWELL TN
37849-1517
US

IV. Provider business mailing address

7557 DANNAHER DR STE G20
POWELL TN
37849-1517
US

V. Phone/Fax

Practice location:
  • Phone: 865-362-8507
  • Fax: 865-205-5601
Mailing address:
  • Phone: 865-332-1302
  • Fax: 865-205-5601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4485
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: