Provider Demographics
NPI:1093764185
Name:SAWICKI, VALERIA ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:ANN
Last Name:SAWICKI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 EAGLE MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-6375
Mailing Address - Country:US
Mailing Address - Phone:423-623-9857
Mailing Address - Fax:
Practice Address - Street 1:215 FORKS OF THE RIVER PKWY STE 2
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-3410
Practice Address - Country:US
Practice Address - Phone:863-908-2838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0068OtherBCBS
S93928Medicare UPIN
FLE3358XMedicare ID - Type Unspecified