Basic Information
Provider Information
NPI: 1134704133
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: TONYA
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: STEELMAN
OtherFirstName: TONYA
OtherMiddleName: E
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1275 DICK LONAS RD UNIT 101
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379091383
CountryCode: US
TelephoneNumber: 8655844747
FaxNumber: 8655841363
Practice Location
Address1: 610 COSBY HWY
Address2:  
City: NEWPORT
State: TN
PostalCode: 378213414
CountryCode: US
TelephoneNumber: 4236257777
FaxNumber: 8339082162
Other Information
ProviderEnumerationDate: 03/11/2021
LastUpdateDate: 03/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X29055TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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