Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 18547 | TN |
NPI | 1003232539 |
---|---|
Provider Name | Emily A. Radcliffe |
First Address | Knoxville, TN 37909-2604 |
Second Address | Knoxville, TN 37923-4341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2014 |
Last Update Date | 10/08/2016 |