Basic Information
Provider Information
NPI: 1396860185
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RECH
FirstName: CAROLINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RNC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: RECH
OtherFirstName: CAROLINE
OtherMiddleName: MARY
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: RNC
OtherLastNameType: 5
Mailing Information
Address1: DEPARTMENT 888182
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379958182
CountryCode: US
TelephoneNumber: 8003553565
FaxNumber: 4237142355
Practice Location
Address1: 627 SMITHVIEW DRIVE
Address2:  
City: MARYVILLE
State: TN
PostalCode: 37803
CountryCode: US
TelephoneNumber: 8653804390
FaxNumber: 8653804396
Other Information
ProviderEnumerationDate: 03/20/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808XRN86578TNY Nursing Service ProvidersRegistered NursePsych/Mental Health

No ID Information.


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