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NPI Code Detail

MEDICARE: ERIN RICHMOND BORUM PMHNP

MEDICARE: ERIN RICHMOND BORUM PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse190665TN
2363LP0808XPsychiatric/Mental Health Nurse Practitioner24641TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013488519
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN RICHMOND BORUM PMHNP
Provider Business Mailing Address
First Line : 200 TECH CENTER DR
Second Line :
City : KNOXVILLE
State : TN
Zip : 37912-2747
Country : US
Telephone Number : 865-637-9711
Fax Number :
Provider Business Practice Location Address
First Line : 5645 MERCHANTS CENTER BLVD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37912-3470
Country : US
Telephone Number : 865-257-9982
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2018
Last Update Date : 03/01/2024

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