Provider Demographics
NPI:1437552577
Name:FOSHIE, KRYSTLE BROOKE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:BROOKE
Last Name:FOSHIE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KRYSTLE
Other - Middle Name:BROOKE
Other - Last Name:SILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:6702 CLINTON HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-1018
Mailing Address - Country:US
Mailing Address - Phone:865-293-4269
Mailing Address - Fax:865-293-4270
Practice Address - Street 1:6702 CLINTON HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-1018
Practice Address - Country:US
Practice Address - Phone:865-293-4269
Practice Address - Fax:865-293-4270
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18934363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ008682Medicaid
TNQ008682Medicaid