Provider Demographics
NPI:1124883848
Name:CHARLES, DENA (NP)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:CHARLES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1934 ALCOA HWY STE D370
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1529
Mailing Address - Country:US
Mailing Address - Phone:865-305-5335
Mailing Address - Fax:865-305-8840
Practice Address - Street 1:1934 ALCOA HWY STE D370
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1529
Practice Address - Country:US
Practice Address - Phone:865-305-5335
Practice Address - Fax:865-305-8840
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily