MEDICARE: AUDREY L. PICKLESIMER MS,RD,LDN

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	133V00000X	Registered Dietitian	1960	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PENDING	OTHER	TN	NON APPLICABLE

General Provider Information

NPI Number	:	1780838920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY L. PICKLESIMER MS,RD,LDN

Provider Business Mailing Address
First Line	:	3420 NEW CORINTH RD
Second Line	:
City	:	BLAINE
State	:	TN
Zip	:	37709-5623
Country	:	US
Telephone Number	:	865-290-0110
Fax Number	:	865-290-0140

Provider Business Practice Location Address
First Line	:	200 PROSPERITY DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-4718
Country	:	US
Telephone Number	:	865-290-0110
Fax Number	:	865-290-0140

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

Provider Enumeration Date	:	11/14/2008
Last Update Date	:	01/03/2025

Similar Medicare Providers

1619830387 — HANNAH HOWARD
Practice Location Address:

200 PROSPERITY PLACE
KNOXVILLE, TN
37923-4718

Practice Phone: 855-832-6727
Practice Fax:

1447112164 — BRITTANY CHEYENNE FAWBUSH
Practice Location Address:

200 PROSPERITY DR
KNOXVILLE, TN
37923-4718

Practice Phone: 855-832-6727
Practice Fax:

1295698231 — EMANUEL OLIVA
Practice Location Address:

200 PROSPERITY PLACE
KNOXVILLE, TN
37923-4718

Practice Phone: 877-845-4014
Practice Fax:

1396860086 — MRS. TAMARA SHARON JOHNSON LCSW
Practice Location Address:

200 PROSPERITY DR STE 206
KNOXVILLE, TN
37923-4718

Practice Phone: 865-317-4244
Practice Fax:

1881883114 — MRS. KRYSTAL L CAMERON RD, LDN
Practice Location Address:

200 PROSPERITY DR
KNOXVILLE, TN
37923-4718

Practice Phone: 865-290-0110
Practice Fax: 865-290-0140

1740556919 — PATRICIA JO BISHOP LCSW
Practice Location Address:

200 PROSPERITY DR STE 220
KNOXVILLE, TN
37923-4718

Practice Phone: 480-313-8175
Practice Fax:

Directions to “ AUDREY L. PICKLESIMER MS,RD,LDN” 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 © 2007-2025 (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.