Provider Demographics
NPI:1205654753
Name:NUTT, MEGAN MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:NUTT
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1926 ALCOA HWY
Mailing Address - Street 2:MEDICAL BUILDING F SUITE 210
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920
Mailing Address - Country:US
Mailing Address - Phone:865-305-2495
Mailing Address - Fax:
Practice Address - Street 1:1926 ALCOA HWY
Practice Address - Street 2:MEDICAL BUILDING F SUITE 210
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-305-2495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN6407363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical