Provider Demographics
NPI:1497529010
Name:MCCARROLL, TONYA S (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:S
Last Name:MCCARROLL
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:SUZETTE
Other - Last Name:TAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2167 SUGAR GROVE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-5030
Mailing Address - Country:US
Mailing Address - Phone:865-466-5350
Mailing Address - Fax:
Practice Address - Street 1:11840 KINGSTON PIKE STE B
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3861
Practice Address - Country:US
Practice Address - Phone:865-588-3173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35082363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health