Individual
THOMAS GERALD KUSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1451 DOWELL SPRINGS BLVD, KNOXVILLE, TN 37909-2441
(865) 970-9800
Mailing address
1451 DOWELL SPRINGS BLVD, KNOXVILLE, TN 37909-2441
(865) 970-9800
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
247954
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28758
TN
Other
Enumeration date
01/09/2021
Last updated
01/22/2021
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