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General NPI Number Information
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NPI Number | 1629590070
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Entity Type | Individual
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Provider Name | EDYTH PATRICIA CERONE NP
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Gender | Female
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 130 MABRY HOOD ROAD SUITE 103
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City | KNOXVILLE
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State | TN
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Zip | 37922
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Country | US
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Telephone | 865-210-4686
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Fax | 866-688-3182
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Provider Business Mailing Address
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Address Line | 1619 NIGHBERT LN
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City | KNOXVILLE
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State | TN
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Zip | 37922-5400
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Country | US
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Telephone | 865-806-2220
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Fax | 865-966-2914
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 22655
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License Number State | TN
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