NPI 1417853706 · live from the CMS NPI Registry
Addison Byrd
Nurse Practitioner, Pediatrics in Johnson City, TN. National Provider Identifier 1417853706, active.
NPI record
| NPI | 1417853706 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 400 N State Of Franklin Rd, Johnson City, TN 37604 |
| Practice phone | 423-431-6111 |
| Mailing address | 829 Indian Trail Dr Apt B34, Kingsport, TN 37660 |
| Enumerated | October 15, 2026 |
| Last updated | October 15, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 42925 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.