Organization
FOUNTAIN OF YOUTH MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVA LYNNE WORTHINGTON FNP-C (FNP-C)
(865) 392-1500
Entity
Organization
Contact information
Practice address
135 LOVELL RD, KNOXVILLE, TN 37934-1904
(865) 392-1400
(865) 392-1402
Mailing address
135 LOVELL RD, KNOXVILLE, TN 37934-1904
(865) 392-1500
(865) 392-1402
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
03/06/2019
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