Provider Demographics
NPI:1295222586
Name:EFFLANDT, ZHANNA YURIEVNA (NP)
Entity Type:Individual
Prefix:
First Name:ZHANNA
Middle Name:YURIEVNA
Last Name:EFFLANDT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ZHANNA
Other - Middle Name:YURIEVNA
Other - Last Name:DMITRIEVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 15004
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37901-5004
Mailing Address - Country:US
Mailing Address - Phone:865-541-8895
Mailing Address - Fax:865-633-4808
Practice Address - Street 1:2100 CLINCH AVE STE 130
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2224
Practice Address - Country:US
Practice Address - Phone:865-546-3111
Practice Address - Fax:865-541-8629
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23697363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ036958Medicaid