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Contact Information

EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER, INC.
2221 JACKSBORO PIKE STE C4
LAFOLLETTE, TN37766-3007
 Phone: 423-566-3488
 Fax: 866-722-3453
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for EAST TENNESSEE CHILDRENS HOSPITAL PRIMARY CARE CENTER INC · (Female)

NPI Number 1366648040
Status Active
Credentials
Entity Individual
Enumeration date 06/21/2007
Last updated 01/14/2026 - About 5 months ago
Sole proprietor 1 Not specified
Identifiers
  • TN Medicaid Q002836
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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