Tatjana Boljanovic, RN

Individual provider Active NPI Community Health Registered Nurse · Knoxville, TN

NPI 1104965607 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104965607
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
RN0000151122 (TN)
Practice address
140 Dameron Ave
Knoxville, TN 37917-6413
Phone
(865) 215-5063
Fax
(865) 215-5391
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN0000151122TNMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN0000151122 TN Yes

Addresses

Primary practice location

140 Dameron Ave
Knoxville, TN 37917-6413

Mailing address

9131 Fox Lake Dr
Knoxville, TN 37923-6446
Phone (865) 531-2532

Other providers in Knoxville, TN

All providers in Knoxville, TN · Community Health Registered Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.