NPI 1215790274 · live from the CMS NPI Registry
Makenna Black
Nurse Practitioner, Pediatrics in Knoxville, TN. National Provider Identifier 1215790274, active.
NPI record
| NPI | 1215790274 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 1930 Alcoa Hwy Ste 145, Knoxville, TN 37920 |
| Practice phone | 865-305-9749 |
| Mailing address | 7216 Hallbrook Rd, Knoxville, TN 37918 |
| Enumerated | February 2, 2024 |
| Last updated | February 2, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 35631 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.