Individual
SHEENA L TULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2428 KNOB CREEK RD STE 102, JOHNSON CITY, TN 37604-2396
(423) 794-1074
(423) 794-1079
Mailing address
6701 BAUM DR STE 140, KNOXVILLE, TN 37919-7361
(865) 584-5727
(865) 450-9904
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
24091
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24091
APN LICENSE
TN
Enumeration date
05/17/2018
Last updated
10/05/2018
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