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

East Tennessee State University

Organization Primary Care Nurse Practitioner · NPI 1508091562

East Tennessee State University is a Primary Care Nurse Practitioner in Jonesborough, Tennessee. Registered with an NPI since 2009.

In the registry since
2009

Practice location Address checks out

684 Old State Route 34
Jonesborough, TN 37659-6094
Phone: (423) 753-0057
Fax: (423) 753-1167
Show map & directions

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

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X

Record details

NPI number1508091562
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Betty King — Acting Chief Financial Officer · (423) 439-4414
Other names David Crockett High School Based Health Clinic
NPI enumeratedMay 20, 2009
Last updated in NPPESFebruary 23, 2017
Mailing address365 Stout Drive Box 70403, Johnson City, TN 37614-1703

Other providers in Jonesborough