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NPI Code Detail

MEDICARE: CATHERINE LEWIS WILSON

MEDICARE: CATHERINE LEWIS WILSON
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
1163WE0003XEmergency Registered Nurse215612TN
2363LA2100XAcute Care Nurse Practitioner27288TN

General Provider Information

NPI Number : 1417589029
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE LEWIS WILSON
Provider Business Mailing Address
First Line : 124 GILBERT LN
Second Line :
City : KNOXVILLE
State : TN
Zip : 37920-3617
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1932 ALCOA HWY STE C270
Second Line :
City : KNOXVILLE
State : TN
Zip : 37920-1537
Country : US
Telephone Number : 865-251-4658
Fax Number : 865-251-4659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2020
Last Update Date : 12/17/2020

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Directions to “ CATHERINE LEWIS WILSON ” Practice Location

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