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General NPI Number Information
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NPI Number | 1477941375
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Entity Type | Organization
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Legal Business Name | EAST TENNESSEE CHILDREN'S HOSPITAL ASSOCIATION INC.
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 2018 CLINCH AVENUE SOUTH TOWER 2ND FLOOR
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City | KNOXVILLE
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State | TN
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Zip | 37916-2301
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Country | US
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Telephone | 865-525-1425
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Fax | 877-935-4221
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Provider Business Mailing Address
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Address Line | PO BOX 15004
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City | KNOXVILLE
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State | TN
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Zip | 37901-5004
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Country | US
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Telephone | 865-541-8895
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Fax | 865-633-4808
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Authorized Official
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Title or Position | CFO / VICE PRESIDENT FINANCE
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Name | CARYN HAWTHORNE
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Credential |
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Telephone | 865-541-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207SG0202X
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Taxonomy Name | Clinical Biochemical Genetics Physician
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License Number |
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License Number State |
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