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General NPI Number Information
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NPI Number | 1073403929
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Entity Type | Organization
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Legal Business Name | HEALTHY MINDS OF APPALACHIA
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 722 JANES RD
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City | MARYVILLE
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State | TN
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Zip | 37801-1729
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Country | US
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Telephone | 865-770-0183
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Fax |
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Provider Business Mailing Address
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Address Line | 722 JANES RD
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City | MARYVILLE
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State | TN
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Zip | 37801-1729
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Country | US
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Telephone | 865-770-0183
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER, APRN
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Name | TRACY PAYNE
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Credential | FNP-C, PMHNP-BC
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Telephone | 865-307-1628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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