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NPI Code Detail

MEDICARE: MS. KATHY LYN WHITE PT

MEDICARE:  MS. KATHY LYN WHITE  PT
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
1225100000XPhysical Therapist1979TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24006505OTHERTNBLUECROSSBLUESHIELD
33654035OTHERTNCIGNA

General Provider Information

NPI Number : 1598783458
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHY LYN WHITE PT
Provider Business Mailing Address
First Line : PO BOX 10565
Second Line :
City : KNOXVILLE
State : TN
Zip : 37939-0565
Country : US
Telephone Number : 865-851-9366
Fax Number : 865-851-9367
Provider Business Practice Location Address
First Line : 4853 CHAMBLISS AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37919-5122
Country : US
Telephone Number : 865-851-9366
Fax Number : 865-851-9367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 08/31/2007

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Directions to “ MS. KATHY LYN WHITE PT” Practice Location

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