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General NPI Number Information
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NPI Number | 1750052072
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Entity Type | Individual
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Provider Name | KRISTINA MICHELLE RODGERS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/27/2021
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 8930 CROSS PARK DR STE 3
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City | KNOXVILLE
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State | TN
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Zip | 37923-4713
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Country | US
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Telephone | 423-271-9911
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Fax |
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Provider Business Mailing Address
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Address Line | 1242 BILL WALLACE DR
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City | FRIENDSVILLE
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State | TN
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Zip | 37737-2558
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Country | US
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Telephone | 865-809-4556
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 30472
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License Number State | TN
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