MEDICARE: NICOLE S BEAVERS CPNP

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
1	363LP0200X	Pediatric Nurse Practitioner	6963	TN

Other Identifiers

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

General Provider Information

NPI Number	:	1477685311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE S BEAVERS CPNP

Provider Business Mailing Address
First Line	:	PO BOX 15004
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37901-5004
Country	:	US
Telephone Number	:	865-541-8895
Fax Number	:	865-633-4808

Provider Business Practice Location Address
First Line	:	2130 N. CHARLES SEIVERS BLVD
Second Line	:	SUITE 4
City	:	CLINTON
State	:	TN
Zip	:	37716-6705
Country	:	US
Telephone Number	:	865-457-4044
Fax Number	:	866-699-4833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	07/08/2025

Similar Medicare Providers

1457557134 — EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.
Practice Location Address:

2130 N CHARLES G SEIVERS BLVD STE 4
CLINTON, TN
37716-6705

Practice Phone: 865-457-4044
Practice Fax: 866-699-4833

1457991713 — ELIZABETH ANN WISHART FNP-BC
Practice Location Address:

2130 N CHARLES G SEIVERS BLVD
CLINTON, TN
37716-6705

Practice Phone: 865-269-4260
Practice Fax:

1780670158 — DR. MELISSA ANNE HOOD MD
Practice Location Address:

2130 N. CHARLES SEIVERS BLVD. , SUITE 4
CLINTON, TN
37716-6705

Practice Phone: 865-457-4044
Practice Fax: 866-699-4833

1932290798 — ORTHOTENNESSEE, PC
Practice Location Address:

2130 N CHARLES G SEIVERS BLVD
CLINTON, TN
37716-6705

Practice Phone: 865-482-9025
Practice Fax: 865-483-8151

1700146909 — JESSICA HUTCHISON CROWE M.D.
Practice Location Address:

2130 N CHARLES SEIVERS BOULEVARD , SUITE 4
CLINTON, TN
37716-6705

Practice Phone: 865-457-4044
Practice Fax: 866-699-4833

1326609074 — LAUREN BLAKLEY APRN, FNP-BC
Practice Location Address:

2130 N CHARLES G SEIVERS BLVD STE 3
CLINTON, TN
37716-6705

Practice Phone: 865-264-4319
Practice Fax: 865-269-4556

Directions to “ NICOLE S BEAVERS CPNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.