Provider Demographics
NPI:1528394236
Name:DAVIDSON, RACHEL WHITE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:WHITE
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
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Mailing Address - Street 1:6701 BAUM DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7360
Mailing Address - Country:US
Mailing Address - Phone:865-584-5727
Mailing Address - Fax:865-450-9904
Practice Address - Street 1:801 N WEISGARBER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2706
Practice Address - Country:US
Practice Address - Phone:865-584-8588
Practice Address - Fax:865-584-3364
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2016-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011913363LP0200X
TN11913363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMD1394600OtherCONTROLLED SUBSTANCE REGISTRATION CERTIFICATE
TNAPN0000011913OtherBOARD OF NURSING: ADVANCED PRACTICE NURSE
TNRN0000145972OtherBOARD OF NURSING: REGISTERED NURSE
TN29470OtherNATIONAL ASSOCIATION NURSE PRACTITIONERS