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Individual

KRISTIN LYNN MIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP, APMHNP

Contact information

Practice address
801 N WEISGARBER RD, SUITE 200, KNOXVILLE, TN 37909-2706
(865) 584-8588
(865) 584-3364
Mailing address
6701 BAUM DR, SUITE 140, KNOXVILLE, TN 37919-7360
(865) 584-5727
(865) 450-9904

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7223
TN
363LF0000X
Family Nurse Practitioner
179647
NC
363LF0000X
Family Nurse Practitioner
APN7223
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
179647
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2592697
MEDICARE
NC
05
7003901
NC
01
P00377624
RAILROAD MEDICARE
NC
Enumeration date
09/12/2005
Last updated
04/09/2014
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