Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 29290 | TN |
NPI | 1003448986 |
---|---|
Provider Name | Caitlin Tabler Bishop |
First Address | Knoxville, TN 37909-3761 |
Second Address | Knoxville, TN 37909-3761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2020 |
Last Update Date | 13/10/2021 |