Provider Demographics
NPI:1134433998
Name:PATMON, CECILY RACHEAL (FNP)
Entity type:Individual
Prefix:
First Name:CECILY
Middle Name:RACHEAL
Last Name:PATMON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CECILY
Other - Middle Name:RACHEAL
Other - Last Name:PARTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:221 IROQUOIS RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-4937
Mailing Address - Country:US
Mailing Address - Phone:865-300-8143
Mailing Address - Fax:
Practice Address - Street 1:2240 SUTHERLAND AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-2333
Practice Address - Country:US
Practice Address - Phone:865-909-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN000015100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily