Provider Demographics
NPI:1174787501
Name:REYNOLDS, WHITNEY HUBBS (CPNP)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:HUBBS
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9625 KROGER PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-5880
Mailing Address - Country:US
Mailing Address - Phone:865-691-3335
Mailing Address - Fax:865-691-3310
Practice Address - Street 1:9625 KROGER PARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-5880
Practice Address - Country:US
Practice Address - Phone:865-691-3335
Practice Address - Fax:865-691-3310
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20040122363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics