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General NPI Number Information
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NPI Number | 1508735200
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Entity Type | Individual
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Provider Name | CAROLYNN CLEMONS RN
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Gender | Female
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Dates
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Enumeration Date | 10/31/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 10820 PARKSIDE DR
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City | KNOXVILLE
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State | TN
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Zip | 37934-1956
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Country | US
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Telephone | 865-230-2031
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Fax |
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Provider Business Mailing Address
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Address Line | 3308 VICKIE KAREN DR
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City | KNOXVILLE
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State | TN
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Zip | 37938-4063
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Country | US
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Telephone | 865-230-2031
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 0000232953
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License Number State | TN
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