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General NPI Number Information
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NPI Number | 1700092707
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Entity Type | Individual
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Provider Name | MRS. MARY EILEEN MCDONALD
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1005 CUMBERLAND VIEW CIR
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City | KNOXVILLE
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State | TN
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Zip | 37912-2910
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Country | US
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Telephone | 865-688-7898
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 CUMBERLAND VIEW CIR
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City | KNOXVILLE
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State | TN
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Zip | 37912-2910
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Country | US
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Telephone | 865-688-7898
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN0000056984
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License Number State | TN
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