Provider Demographics
NPI:1326155573
Name:BERTRAM, FELICIA ANN (ARNP)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ANN
Last Name:BERTRAM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:ANN
Other - Last Name:INMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2606 GREENWAY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-1991
Mailing Address - Country:US
Mailing Address - Phone:865-687-3313
Mailing Address - Fax:865-687-3362
Practice Address - Street 1:2606 GREENWAY DR STE 101
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-1991
Practice Address - Country:US
Practice Address - Phone:865-687-3313
Practice Address - Fax:865-687-3362
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9176222363LF0000X
TN14456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN0000014456OtherSTATE OF TENNESSEE BOARD OF NURSING LICENSE