Judith Lee Black, RN-BC

Individual provider Active NPI Ambulatory Care Registered Nurse · Knoxville, TN

NPI 1447732995 · NPPES record last updated Aug 31, 2018

Key facts

NPI
1447732995
Entity type
Individual (NPI type 1)
Primary specialty
Ambulatory Care Registered Nurse 163WP2201X
License
112463 (TN)
Practice address
2018 Western Ave
Knoxville, TN 37921-5718
Phone
(865) 544-0406
Fax
(865) 544-0480
NPI assigned
Aug 31, 2018
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
112463TNMDAmbulatory Care Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 112463 TN Yes

Addresses

Primary practice location

2018 Western Ave
Knoxville, TN 37921-5718

Mailing address

1923 Sulphur Springs Rd
Morristown, TN 37813-5654
Phone (423) 317-9344

Other names

  • Judith Lee Dwyer Former name

Other providers in Knoxville, TN

All providers in Knoxville, TN · Ambulatory Care Registered Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.