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Individual

BETHANY RUNIONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
2212 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2903
(423) 566-8181
(833) 908-2077
Mailing address
1275 DICK LONAS RD UNIT 101, KNOXVILLE, TN 37909-1383
(865) 584-4747
(865) 381-1509

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
193906
TN
363LF0000X
Family Nurse Practitioner
Primary
36334
TN

Other

Enumeration date
10/25/2022
Last updated
12/17/2024
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