Healthcare Provider Details

I. General information

NPI: 1538436183
Provider Name (Legal Business Name): DEBRA TROUTMAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2011
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3614 UNICOI DR
UNICOI TN
37692-6860
US

IV. Provider business mailing address

228 DOGWOOD ACRES RD
HAMPTON TN
37658-3348
US

V. Phone/Fax

Practice location:
  • Phone: 423-743-7151
  • Fax:
Mailing address:
  • Phone: 423-725-2314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000014380
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: