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Individual

MAKENNA BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1930 ALCOA HWY STE 145, KNOXVILLE, TN 37920-1546
(865) 305-9749
Mailing address
7216 HALLBROOK RD, KNOXVILLE, TN 37918-9419

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
35631
TN

Other

Enumeration date
02/02/2024
Last updated
02/02/2024
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