MEDICARE: MERIAH ROSE HEWITT PA-C

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1558241828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERIAH ROSE HEWITT PA-C

Provider Business Mailing Address
First Line	:	312 PRINCE ST
Second Line	:
City	:	SEVIERVILLE
State	:	TN
Zip	:	37862-3823
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1338 RUSSELL AVE STE 200
Second Line	:
City	:	JEFFERSON CITY
State	:	TN
Zip	:	37760-2761
Country	:	US
Telephone Number	:	865-262-0106
Fax Number	:	865-262-0049

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

Provider Enumeration Date	:	09/05/2025
Last Update Date	:	05/27/2026

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