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Individual

MR. JOE DAVID MOTTERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1410 TUSCULUM BLVD, SUITE 2300, GREENEVILLE, TN 37745-4286
(423) 823-5190
(423) 823-5193
Mailing address
6701 BAUM DR, SUITE 140, KNOXVILLE, TN 37919-7360
(865) 584-5727
(865) 450-9904

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN00000100379
TN
363LF0000X
Family Nurse Practitioner
APN6999
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3903820
TN
05
3903821
TN
05
3903822
TN
05
3903827
TN
05
3903829
TN
01
S58833
UPIN
TN
Enumeration date
06/01/2006
Last updated
02/28/2012
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