Individual
MACKENZIE TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1924 ALCOA HWY, KNOXVILLE, TN 37920-1511
(865) 305-9000
Mailing address
1852 CHEROKEE BLUFF DR, KNOXVILLE, TN 37920-2215
(615) 587-4935
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
216365
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
30846
TN
Other
Enumeration date
04/24/2020
Last updated
12/30/2021
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