Provider Demographics
NPI:1912291501
Name:PERCER, BETH E (APN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:E
Last Name:PERCER
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 1:9430 PARKWEST BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923
Mailing Address - Country:US
Mailing Address - Phone:865-769-4444
Mailing Address - Fax:865-769-4419
Practice Address - Street 1:9430 PARKWEST BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923
Practice Address - Country:US
Practice Address - Phone:865-769-4444
Practice Address - Fax:865-769-4419
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014179363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN0000014179OtherAPN STATE LICENSE