Healthcare Provider Details

I. General information

NPI: 1780004002
Provider Name (Legal Business Name): TASKA L MORELOCK PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2014
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 MIDDLE CREEK RD
SEVIERVILLE TN
37862-5019
US

IV. Provider business mailing address

1431 CENTERPOINT BLVD SUITE 100
KNOXVILLE TN
37932-1984
US

V. Phone/Fax

Practice location:
  • Phone: 865-446-8800
  • Fax: 865-560-8960
Mailing address:
  • Phone: 865-539-8000
  • Fax: 865-560-8960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2490
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2490
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: