Provider Demographics
NPI:1538104617
Name:PATEL, HEENA (FNP)
Entity Type:Individual
Prefix:
First Name:HEENA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1934 ALCOA HWY STE 285
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1528
Mailing Address - Country:US
Mailing Address - Phone:865-305-9620
Mailing Address - Fax:865-525-3460
Practice Address - Street 1:1934 ALCOA HWY STE 285
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1528
Practice Address - Country:US
Practice Address - Phone:865-305-9620
Practice Address - Fax:865-525-3460
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8117363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3349776Medicaid
TNP00391976OtherRR MEDICARE PIN
Q00436Medicare UPIN
TN3349776Medicare ID - Type UnspecifiedLEGACY PIN
TNP00391976OtherRR MEDICARE PIN