Provider Demographics
NPI:1114027224
Name:DAYSPRING FAMILY CARE PLLC
Entity Type:Organization
Organization Name:DAYSPRING FAMILY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEWEESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-548-4477
Mailing Address - Street 1:7341 CHAPMAN HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-6681
Mailing Address - Country:US
Mailing Address - Phone:865-548-4477
Mailing Address - Fax:
Practice Address - Street 1:7341 CHAPMAN HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-6681
Practice Address - Country:US
Practice Address - Phone:865-577-9212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000000971363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ16725Medicare UPIN
TNH60701Medicare UPIN