Provider Demographics
NPI:1538101209
Name:CRYE, CAROL D (NP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:D
Last Name:CRYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 CLINCH AVENUE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:KNOXVILLE
Mailing Address - State:TENNESSEE
Mailing Address - Zip Code:37916
Mailing Address - Country:UM
Mailing Address - Phone:865-541-2835
Mailing Address - Fax:865-541-1003
Practice Address - Street 1:1819 W CLINCH AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2434
Practice Address - Country:US
Practice Address - Phone:865-541-2835
Practice Address - Fax:865-541-1003
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN74483363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3342873Medicaid
TN3342873Medicaid