TALISHA ETTINA LEEANN TROUTT FNP NPI 1639696784

NPI Information

NPI: 1639696784
Provider Name: TALISHA ETTINA LEEANN TROUTT, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
365 STOUT DRIVE
SUITE 160
JOHNSON CITY, TN
ZIP 37614
Phone: (423) 439-4225
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Talisha Ettina Leeann Troutt, FNP is a family nurse practitioner in Johnson City, TN. Talisha Ettina Leeann Troutt, FNP NPI is 1639696784. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

365 STOUT DRIVE
SUITE 160
JOHNSON CITY, TN
ZIP 37614-761
Phone: (423) 439-4225
Fax: (423) 439-4560

The NPI 1639696784 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/29/2017 and was last updated on 3/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	23083	TENNESSEE	No
2	363LF0000X	Nurse Practitioner	Family	23083	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q036951	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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