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NPI Code Detail

MEDICARE: SAMANTHA HUDSON PURNELL FNP

MEDICARE: SAMANTHA HUDSON PURNELL FNP
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
1363LF0000XFamily Nurse Practitioner17498TN

General Provider Information

NPI Number : 1649512641
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA HUDSON PURNELL FNP
Provider Business Mailing Address
First Line : 1275 DICK LONAS RD UNIT 101
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-1383
Country : US
Telephone Number : 865-584-4747
Fax Number : 865-584-1363
Provider Business Practice Location Address
First Line : 9333 PARK WEST BLVD STE 200
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4317
Country : US
Telephone Number : 865-531-4600
Fax Number : 865-690-2271
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2013
Last Update Date : 09/11/2019

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