Individual
REBECCA JOHNSON AGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
224 S PETERS ROAD SUITE 105, KNOXVILLE, TN 37923
(865) 470-8844
(866) 479-4403
Mailing address
PO BOX 15004, KNOXVILLE, TN 37901-5004
(865) 541-8895
(865) 633-4808
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5654
TN
2080A0000X
Pediatric Adolescent Medicine Physician
5654
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q091874
—
TN
Enumeration date
03/22/2019
Last updated
01/29/2025
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