Provider Demographics
NPI:1629524855
Name:CHAFFINS, BENJAMIN SETH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:SETH
Last Name:CHAFFINS
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 PARKWEST BOULEVARD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923
Mailing Address - Country:US
Mailing Address - Phone:865-373-7942
Mailing Address - Fax:865-373-7235
Practice Address - Street 1:9330 PARK WEST BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4308
Practice Address - Country:US
Practice Address - Phone:865-373-7942
Practice Address - Fax:865-373-7235
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ023938Medicaid
TNQ023938Medicaid