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General NPI Number Information
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NPI Number | 1588701940
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Entity Type | Individual
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Provider Name | CARISSA L WHALEY R.N.
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Gender | Female
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 1006 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5132
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Country | US
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Telephone | 865-983-4582
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Fax |
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Provider Business Mailing Address
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Address Line | 726 WINSTON DR
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City | SEYMOUR
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State | TN
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Zip | 37865-3423
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Country | US
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Telephone | 865-983-4582
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 0000120545
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License Number State | TN
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