Provider Demographics
NPI:1538463310
Name:CARMICHAEL, STEPHANIE L (FNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5837 LYONS VIEW PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-6474
Mailing Address - Country:US
Mailing Address - Phone:865-200-1035
Mailing Address - Fax:844-517-2447
Practice Address - Street 1:5837 LYONS VIEW PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6474
Practice Address - Country:US
Practice Address - Phone:865-200-1035
Practice Address - Fax:844-517-2447
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN154808163W00000X
TN15533363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily