Provider Demographics
NPI:1538139290
Name:BEFFREY, AMY BOYNTON (FNP)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:BOYNTON
Last Name:BEFFREY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:B
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:4109 PLEASANT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-6125
Mailing Address - Country:US
Mailing Address - Phone:865-310-7423
Mailing Address - Fax:865-637-0454
Practice Address - Street 1:4109 PLEASANT RIDGE RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-6125
Practice Address - Country:US
Practice Address - Phone:865-310-7423
Practice Address - Fax:865-637-0454
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0275911-22363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN33451881Medicare UPIN