Provider Demographics
NPI:1538618988
Name:BOTTOMLEY, ABIGAIL (NP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:BOTTOMLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 DEL MONTE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2401
Mailing Address - Country:US
Mailing Address - Phone:831-622-6930
Mailing Address - Fax:831-622-6931
Practice Address - Street 1:10810 PARKSIDE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1979
Practice Address - Country:US
Practice Address - Phone:865-218-6250
Practice Address - Fax:865-218-6251
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily