Provider Demographics
NPI:1760909816
Name:DUNCAN, CALLIE H (CPNP)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:H
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5505 CREEKWOOD PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-1201
Mailing Address - Country:US
Mailing Address - Phone:865-986-1400
Mailing Address - Fax:865-986-9400
Practice Address - Street 1:136 MOUNTAIN PERKINS LN STE 2
Practice Address - Street 2:
Practice Address - City:JACKSBORO
Practice Address - State:TN
Practice Address - Zip Code:37757-2841
Practice Address - Country:US
Practice Address - Phone:423-562-4149
Practice Address - Fax:423-566-6929
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN23207363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics