Provider Demographics
NPI:1194764746
Name:ABERDEEN, KATRINA T (APRN-BC)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:T
Last Name:ABERDEEN
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:865-694-0062
Mailing Address - Fax:865-694-7907
Practice Address - Street 1:9430 PARK WEST BLVD STE 130
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4205
Practice Address - Country:US
Practice Address - Phone:865-690-4861
Practice Address - Fax:865-560-8525
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12009363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN0000012009OtherAPN STATE LICENSE
TN4245677OtherBLUECROSS BLUESHIELD OF TENNESSEE
TN1512057Medicaid
TN4245677OtherBLUECROSS BLUESHIELD OF TENNESSEE
TNMA1395249OtherDEA
3376148Medicare PIN
3376144Medicare PIN
TNAPN0000012009OtherAPN STATE LICENSE
1035090I18Medicare PIN
TN1512057Medicaid