Provider Demographics
NPI:1174238984
Name:DUNCAN, RAELAN (NP)
Entity type:Individual
Prefix:
First Name:RAELAN
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RAELAN
Other - Middle Name:
Other - Last Name:PENNINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19536 ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-3382
Mailing Address - Country:US
Mailing Address - Phone:423-569-3278
Mailing Address - Fax:423-569-4414
Practice Address - Street 1:19536 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-3382
Practice Address - Country:US
Practice Address - Phone:423-569-3278
Practice Address - Fax:423-569-4414
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33157363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily