Provider Demographics
NPI:1518393834
Name:SEAL, BRITTANY MEGAN
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MEGAN
Last Name:SEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:MEGAN
Other - Last Name:OGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1225 E WEISGARBER RD
Mailing Address - Street 2:STE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2675
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-381-1509
Practice Address - Street 1:1817 W MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2837
Practice Address - Country:US
Practice Address - Phone:423-581-3904
Practice Address - Fax:423-581-6120
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23473363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ035410Medicaid