Provider Demographics
NPI:1184039984
Name:CARTER, PATRICIA LYNN TILLEY (FNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA LYNN
Middle Name:TILLEY
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:T
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:421 HEATHERMOOR DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-2560
Mailing Address - Country:US
Mailing Address - Phone:865-591-8156
Mailing Address - Fax:
Practice Address - Street 1:421 HEATHERMOOR DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-2560
Practice Address - Country:US
Practice Address - Phone:865-591-8156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPRN0000018961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily