Individual
CHARLES JACOB CUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
202 DOHI DR, LOUDON, TN 37774-2851
(865) 205-3025
(833) 908-2125
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
363LF0000X
Family Nurse Practitioner
Primary
34212
TN
Other
Enumeration date
07/10/2023
Last updated
04/14/2025
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