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General NPI Number Information
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NPI Number | 1184629735
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Entity Type | Organization
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Legal Business Name | ADVANTAGE FAMILY HEALTHCARE, PLLC
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Dates
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Enumeration Date | 06/19/2005
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Last Update Date | 05/03/2011
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Provider Practice Location Address
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Address Line | 11541 KINGSTON PIKE STE 101
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City | KNOXVILLE
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State | TN
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Zip | 37934-3918
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Country | US
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Telephone | 865-675-7522
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Fax | 865-671-3196
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Provider Business Mailing Address
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Address Line | 11541 KINGSTON PIKE STE 101
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City | KNOXVILLE
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State | TN
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Zip | 37934-3918
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Country | US
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Telephone | 865-675-7522
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Fax | 865-671-3196
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Authorized Official
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Title or Position | CHIEF MANAGER / PROVIDER
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Name | MR. ROBERT MICHAEL MARTIN
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Credential | MS, CFNP
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Telephone | 865-675-7522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN7953
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License Number State | TN
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