Provider Demographics
NPI:1588792899
Name:MATHIS, EMILY L (FNP)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:L
Last Name:MATHIS
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1001 HUNTERS GREEN RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-2498
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2732 US HIGHWAY 411 S
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-3104
Practice Address - Country:US
Practice Address - Phone:865-681-5277
Practice Address - Fax:865-681-5278
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN142133163W00000X
TN12635363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509874Medicaid
TN1053480004OtherMEDICARE NPI GROUP
TN1053480004OtherMEDICARE NPI GROUP