Provider Demographics
NPI:1386934396
Name:BISS, MARY JO STONE (APN)
Entity type:Individual
Prefix:
First Name:MARY JO
Middle Name:STONE
Last Name:BISS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11440 PARKSIDE DRIVE
Mailing Address - Street 2:#302
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11440 PARKSIDE DRIVE
Practice Address - Street 2:#302
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934
Practice Address - Country:US
Practice Address - Phone:865-218-9220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15720363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner