Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

East Tennessee State University

Organization Family Nurse Practitioner · NPI 1275902884

East Tennessee State University is a Family Nurse Practitioner in Johnson City, Tennessee. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address checks out

1000 N Roan St
Johnson City, TN 37601-4616
Phone: (423) 434-5249
Fax: (423) 434-5295
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1275902884
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Betty King — Acting Chief Financial Officer · (423) 439-4414
Other names Northside Elementary School Clinic
NPI enumeratedSeptember 24, 2015
Last updated in NPPESFebruary 23, 2017
Mailing address365 Stout Drive Box 70403, Johnson City, TN 37614-1703

Other providers in Johnson City