Individual
BLAIR KAITLYN COPPENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2100 CLINCH AVE STE 120, KNOXVILLE, TN 37916-2288
(865) 804-2107
Mailing address
2100 CLINCH AVE STE 120, KNOXVILLE, TN 37916-2288
(865) 637-7290
(865) 637-7289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
08/26/2020
Last updated
02/01/2022
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