Provider Demographics
NPI:1134745755
Name:MARTIN, TORI D (APN)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:D
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PARK 40 NORTH BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-3624
Mailing Address - Country:US
Mailing Address - Phone:865-692-3462
Mailing Address - Fax:865-670-6333
Practice Address - Street 1:320 PARK 40 NORTH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-3624
Practice Address - Country:US
Practice Address - Phone:865-692-3462
Practice Address - Fax:865-670-6333
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27728363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily