Provider Demographics
NPI:1699877142
Name:ROY, MERRY STEPHENSON (ARNP)
Entity type:Individual
Prefix:
First Name:MERRY
Middle Name:STEPHENSON
Last Name:ROY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MERRY
Other - Middle Name:CAROL
Other - Last Name:STEPHENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2759 OCTAVIA WAY
Mailing Address - Street 2:
Mailing Address - City:MASCOT
Mailing Address - State:TN
Mailing Address - Zip Code:37806-1827
Mailing Address - Country:US
Mailing Address - Phone:865-406-4630
Mailing Address - Fax:
Practice Address - Street 1:9200 MIDDLEBROOK PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-4701
Practice Address - Country:US
Practice Address - Phone:865-824-4279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007783363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily