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General NPI Number Information
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NPI Number | 1467025742
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Entity Type | Individual
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Provider Name | KRISTEN AMBURN CLOUSE FNP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 10408 JACKSON OAKS WAY
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City | KNOXVILLE
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State | TN
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Zip | 37922-3293
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Country | US
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Telephone | 865-692-3433
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Fax |
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Provider Business Mailing Address
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Address Line | 606 CALTHORPE LN
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City | KNOXVILLE
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State | TN
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Zip | 37912-2145
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Country | US
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Telephone | 865-804-8479
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 29560
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 224577
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License Number State | TN
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