Healthcare Provider Details

I. General information

NPI: 1063989739
Provider Name (Legal Business Name): RACHEL DIANE KOHN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 FOX MEADOWS BLVD
SEVIERVILLE TN
37862-6939
US

IV. Provider business mailing address

1422 OLD WEISGARBER RD
KNOXVILLE TN
37909-1293
US

V. Phone/Fax

Practice location:
  • Phone: 865-366-1581
  • Fax:
Mailing address:
  • Phone: 658-558-4400
  • Fax: 865-558-4421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3687
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: