Provider Demographics
NPI:1598853616
Name:ABEL, DENISE S (PA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:S
Last Name:ABEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W PRICE RD
Mailing Address - Street 2:
Mailing Address - City:DANDRIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37725-4524
Mailing Address - Country:US
Mailing Address - Phone:865-475-6161
Mailing Address - Fax:865-475-9857
Practice Address - Street 1:150 W PRICE RD
Practice Address - Street 2:
Practice Address - City:DANDRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37725-4524
Practice Address - Country:US
Practice Address - Phone:865-475-6161
Practice Address - Fax:865-475-9857
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000001153363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1505762Medicaid
TN36631102OtherMEDICARE PTAN
TN1505762Medicaid
TNS89412Medicare UPIN
TN3663110Medicare ID - Type Unspecified