Roberta F Blasenak, RN, CPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Sevierville, TN
NPI 1700993201 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1700993201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 4072466 (TN)
- Practice address
- 801 Middle Creek Rd
Sevierville, TN 37862-5018 - Phone
- (865) 453-4434
- Fax
- (865) 428-3508
- NPI assigned
- Aug 23, 2006
- 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
- Credentials
- Certified Pediatric Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4072466 | TN | MD | Pediatric Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 4072466 | TN | Yes |
Addresses
Primary practice location
801 Middle Creek Rd
Sevierville, TN 37862-5018
Mailing address
4559 Whetstone Rd
Sevierville, TN 37862-8195
Phone (865) 774-6471
Other providers in Sevierville, TN
- Clyde Emmitt Blair
- Melissa Renea Blair
- Maria Blalock
- Cassidee Blankenship
- Kayla Blankenship
- BLC Wellington - Sevierville, LLC
- Mackenzie Elizabeth Bleazard
- Dana Nicole Bobeck
- Randy Scott Boggs
- Luke Bolin
All providers in Sevierville, TN · Pediatric Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.