Larson, Jill Dyvon

Larson, Jill Dyvon is an individual health care provider with primary practice located at 3118 Alcoa Hwy , Knoxville TN 37920-4791. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Larson, Jill Dyvon can be contacted via phone (865) 314-7125.

Contact Information

Primary practice address
3118 Alcoa Hwy Knoxville TN 37920-4791
Phone: (865) 314-7125
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 12618 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 12618 Tennessee

Profile Details

NPI number 1477678696
LBN Legal business name Larson, Jill Dyvon
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Feb 19th, 2020 - about 6 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 1477678696 NPPES
Tennessee MEDICAID 1510344

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