Dameron, Basilia Pendleton

Dameron, Basilia Pendleton is an individual health care provider with primary practice located at 2100 Clinch Avenue Suite 510 , Knoxville TN 37916-2225. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Dameron, Basilia Pendleton can be contacted via phone (865) 824-4939.

Contact Information

Primary practice address
2100 Clinch Avenue Suite 510 Knoxville TN 37916-2225
Phone: (865) 824-4939
Fax: (866) 630-2013
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X APN0000021065 Tennessee

Profile Details

NPI number 1700230356
LBN Legal business name Dameron, Basilia Pendleton
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2016
Last updated Jun 21st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700230356 NPPES
Tennessee MEDICAID Q022607

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