Provider Demographics
NPI:1487161717
Name:MACFADDEN, PATRICIA LEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LEE
Last Name:MACFADDEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 GREENWAY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-1991
Mailing Address - Country:US
Mailing Address - Phone:865-687-3313
Mailing Address - Fax:865-687-3362
Practice Address - Street 1:186 AIRPORT PLAZA BLVD STE E
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-3197
Practice Address - Country:US
Practice Address - Phone:865-687-3313
Practice Address - Fax:865-687-3362
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000023391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily