Individual
MRS. JILL DYVON LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3118 ALCOA HWY, KNOXVILLE, TN 37920-4791
(865) 314-7125
Mailing address
3118 ALCOA HWY, KNOXVILLE, TN 37920-4791
(865) 314-7125
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12618
TN
363LW0102X
Women's Health Nurse Practitioner
12618
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510344
—
TN
Enumeration date
03/20/2007
Last updated
02/19/2020
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