Individual
BETHANY GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
205 W SPRINGDALE AVE, KNOXVILLE, TN 37917-5158
(865) 637-9711
Mailing address
200 TECH CENTER DR, KNOXVILLE, TN 37912-2747
(865) 637-9711
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
13739
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
13739
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1512108
—
TN
Enumeration date
11/06/2008
Last updated
03/01/2024
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