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General NPI Number Information
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NPI Number | 1659976470
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Entity Type | Organization
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Legal Business Name | EVOLVE HEALTH, PLLC
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 11519 KINGSTON PIKE # 113
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City | KNOXVILLE
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State | TN
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Zip | 37934-3918
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Country | US
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Telephone | 702-706-6029
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Fax |
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Provider Business Mailing Address
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Address Line | 11519 KINGSTON PIKE # 113
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City | KNOXVILLE
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State | TN
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Zip | 37934-3918
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER / FAMILY NURSE PRACTITIONER
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Name | HEATHER JOACHIM
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Credential | FNP-C
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Telephone | 702-706-6029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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