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General NPI Number Information
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NPI Number | 1245557859
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Entity Type | Individual
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Provider Name | JENNIFER LYN CONRAD-RENDON NP-C
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Gender | Female
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 11808 KINGSTON PIKE STE 130
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City | KNOXVILLE
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State | TN
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Zip | 37934-3831
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Country | US
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Telephone | 901-487-3814
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Fax | 901-410-8345
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Provider Business Mailing Address
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Address Line | 11808 KINGSTON PIKE STE 130
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City | KNOXVILLE
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State | TN
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Zip | 37934-3831
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Country | US
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Telephone | 901-487-3814
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Fax | 901-410-8345
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 14921
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 14921
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License Number State | TN
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