Provider Demographics
NPI:1174968036
Name:ATKINS, SUSAN JANE (WHNP-BC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:JANE
Last Name:ATKINS
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:2700 PAINTER AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4639
Mailing Address - Country:US
Mailing Address - Phone:865-525-4673
Mailing Address - Fax:865-523-2257
Practice Address - Street 1:2700 PAINTER AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4639
Practice Address - Country:US
Practice Address - Phone:865-525-4673
Practice Address - Fax:865-523-2257
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7225363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health