Provider Demographics
NPI:1427872290
Name:COMMUNITY WELLNESS PARTNERS, PLLC
Entity type:Organization
Organization Name:COMMUNITY WELLNESS PARTNERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER. NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ASHTON
Authorized Official - Middle Name:
Authorized Official - Last Name:MENCER WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:865-230-1500
Mailing Address - Street 1:316 VANOSDALE RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-3027
Mailing Address - Country:US
Mailing Address - Phone:865-230-1500
Mailing Address - Fax:844-591-0908
Practice Address - Street 1:5113 KINGSTON PIKE STE D4
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5183
Practice Address - Country:US
Practice Address - Phone:865-230-1500
Practice Address - Fax:844-591-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care