MEDICARE: EVY O'BRIEN

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1871489518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVY O'BRIEN

Provider Business Mailing Address
First Line	:	200 TECH CENTER DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-2747
Country	:	US
Telephone Number	:	865-637-9711
Fax Number	:

Provider Business Practice Location Address
First Line	:	6055 SHALLOWFORD RD
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-1688
Country	:	US
Telephone Number	:	423-266-6751
Fax Number	:

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

Provider Enumeration Date	:	06/17/2025
Last Update Date	:	06/02/2026

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Directions to “ EVY O'BRIEN ” Practice Location

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