Basic Information
Provider Information
NPI: 1487910485
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HEATH
FirstName: LINDSAY
MiddleName: JEAN
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1923 SULPHUR SPRINGS RD
Address2:  
City: MORRISTOWN
State: TN
PostalCode: 378135654
CountryCode: US
TelephoneNumber: 4233179344
FaxNumber:  
Practice Location
Address1: 2202 MARTIN LUTHER KING JR AVE
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379151570
CountryCode: US
TelephoneNumber: 8655226097
FaxNumber: 8655401615
Other Information
ProviderEnumerationDate: 04/04/2012
LastUpdateDate: 09/30/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/30/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X161160TNN Nursing Service ProvidersRegistered Nurse 
363LF0000X26815TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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