Basic Information
| Provider Information | |||||||||
| NPI: | 1285973362 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUTHRIE | ||||||||
| FirstName: | OLIVIA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9129 CROSS PARK DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379234505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656947725 | ||||||||
| FaxNumber: | 8654834194 | ||||||||
| Practice Location | |||||||||
| Address1: | 9430 PARK WEST BLVD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379234200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656948353 | ||||||||
| FaxNumber: | 8656930338 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2013 | ||||||||
| LastUpdateDate: | 06/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 2288 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.