Individual
RAVEN MICHELLE HEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
90 VERMONT AVE STE 300, OAK RIDGE, TN 37830
(865) 481-2541
(865) 483-8151
Mailing address
256 FORT SANDERS WEST BLVD STE 200, KNOXVILLE, TN 37922-3355
(865) 769-4500
(865) 769-4501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
23818
TN
Other
Enumeration date
02/07/2018
Last updated
08/08/2018
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