Provider Demographics
NPI:1023268638
Name:BOTTOMS, CHRISTY BROOKE (CNM)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:BROOKE
Last Name:BOTTOMS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 E EMERALD AVE STE 614
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-4555
Mailing Address - Country:US
Mailing Address - Phone:865-647-3920
Mailing Address - Fax:865-647-3929
Practice Address - Street 1:930 E EMERALD AVE STE 614
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917
Practice Address - Country:US
Practice Address - Phone:865-647-3920
Practice Address - Fax:865-647-3929
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13519367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3660250Medicare PIN