Healthcare Provider Details

I. General information

NPI: 1619271277
Provider Name (Legal Business Name): STEFANI D NEVILS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2010
Last Update Date: 11/23/2024
Certification Date: 11/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 HOSPITAL RD
WINCHESTER TN
37398-2404
US

IV. Provider business mailing address

6734 LA CHRISTA WAY
KNOXVILLE TN
37921-2139
US

V. Phone/Fax

Practice location:
  • Phone: 931-967-8251
  • Fax:
Mailing address:
  • Phone: 770-361-8910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPN15474
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: