Provider Demographics
NPI:1821022716
Name:BARTLETT, CHARLIE M (FNP)
Entity Type:Individual
Prefix:
First Name:CHARLIE
Middle Name:M
Last Name:BARTLETT
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 1:10321 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3224
Mailing Address - Country:US
Mailing Address - Phone:865-584-3565
Mailing Address - Fax:865-909-0003
Practice Address - Street 1:10321 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3224
Practice Address - Country:US
Practice Address - Phone:865-584-3565
Practice Address - Fax:865-909-0003
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN151508363L00000X
TNAPN11556363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00312077OtherRAILROAD MEDICARE
TN3642540Medicaid
TN4115099OtherBLUE CROSS
TN4115099OtherBLUE CROSS