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General NPI Number Information
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NPI Number | 1487553616
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Entity Type | Organization
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Legal Business Name | GRACEFUL HEALING & MENTAL WELLNESS PLLC
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 111 CENTER PARK DR STE 1300
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City | KNOXVILLE
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State | TN
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Zip | 37922-2124
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Country | US
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Telephone | 865-407-1136
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Fax | 865-381-0767
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Provider Business Mailing Address
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Address Line | 111 CENTER PARK DR STE 1300
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City | KNOXVILLE
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State | TN
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Zip | 37922-2124
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Country | US
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Telephone | 865-407-1136
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Fax | 865-381-0767
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Authorized Official
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Title or Position | PMHNP-BC
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Name | ANDREA DEMARIA
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Credential | APRN
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Telephone | 865-407-1136
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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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