Provider Demographics
NPI:1104811678
Name:CADMUS, MAUREEN THERESA (MSN APN RN)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:THERESA
Last Name:CADMUS
Suffix:
Gender:F
Credentials:MSN APN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 LAUREL AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1819
Mailing Address - Country:US
Mailing Address - Phone:865-673-0288
Mailing Address - Fax:865-522-8712
Practice Address - Street 1:2001 LAUREL AVE
Practice Address - Street 2:STE 204
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1819
Practice Address - Country:US
Practice Address - Phone:865-673-0288
Practice Address - Fax:865-522-8712
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007944363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN368278Medicaid
TN3705001Medicaid
TN368278Medicaid
Q38802Medicare UPIN
3705001Medicare ID - Type UnspecifiedGROUP