Basic Information
| Provider Information | |||||||||
| NPI: | 1699921338 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAPAROS | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | BROWN | ||||||||
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| Credential: | PA | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BROWN | ||||||||
| OtherFirstName: | HEATHER | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1934 ALCOA HWY | ||||||||
| Address2: | BLDG. D, SUITE 362 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379201524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8653054670 | ||||||||
| FaxNumber: | 8653054671 | ||||||||
| Practice Location | |||||||||
| Address1: | 1934 ALCOA HWY | ||||||||
| Address2: | BLDG. D, SUITE 362 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379201524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8653054670 | ||||||||
| FaxNumber: | 8653054671 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2008 | ||||||||
| LastUpdateDate: | 09/20/2017 | ||||||||
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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 | 363A00000X | C03061 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 1869 | TN | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AS0400X | C03061 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363AS0400X | 1869 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | 4273256 | 01 | TN | BLUECROSS BLUESHIELD | OTHER | 1520891 | 05 | TN | MEDICAID | 4273258 | 01 | TN | BLUECROSS BLUESHIELD -AT SURGERY | OTHER |