Patricia Sullivan Zetterberg, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

14827 Issued in TN

Practice address

2018 Clinch Ave
Knoxville, TN 37916-2301

Phone

(865) 541-8830

Fax

(865) 541-8405

NPI assigned

Mar 15, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1548584964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15004",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015004",
            "telephone_number": "865-541-8895",
            "fax_number": "865-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162301",
            "telephone_number": "865-541-8830",
            "fax_number": "865-541-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZETTERBERG",
        "first_name": "PATRICIA",
        "middle_name": "SULLIVAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-15",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "14827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q002741",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.