Provider Demographics
NPI:1588807523
Name:CANNINGTON, VICKI F (APRN)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:F
Last Name:CANNINGTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 440504
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0504
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6188
Practice Address - Street 1:1934 ALCOA HWY
Practice Address - Street 2:STE 473
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1524
Practice Address - Country:US
Practice Address - Phone:865-305-3035
Practice Address - Fax:865-305-7115
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14057363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514046Medicaid
TN1514046Medicaid