TALISHA ETTINA LEEANN TROUTT (NPI# 1639696784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639696784 |
| Entity Type | Individual |
| Full Name | TALISHA ETTINA LEEANN TROUTT |
| Credential | FNP |
| Practice Address |
365 Stout Drive Suite 160 Johnson City TN 37614-3761 |
| Mailing Address |
Po Box 70403 Johnson City TN 37614-1703 |
| Practice Telephone | 4234394225 |
| Practice Fax Number | 4234394560 |
| Mailing Telephone | 4234394381 |
| Mailing Fax Number | 4234394543 |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2020-03-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
23083 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
23083 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q036951 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 132 Old Gray Station Rd, Gray, TN 37615 | 4234678001 | 4234678003 |
| 2020 Brookside Dr Ste 20, Kingsport, TN 376604658 | (423) 247-7030 | 4232477033 |
| Street Address |
365 STOUT DRIVE SUITE 160 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37614-3761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568570273 | East Tennessee State University | Nurse Practitioner | 365 Stout Drive, Nicks Hall Rm 160, Johnson City, TN 37614-6500 | 2006-08-25 |
| 1558806745 | Meira Yasin | Nurse Practitioner | 365 Stout Drive, Suite 160, Johnson City, TN 37614-1703 | 2016-12-27 |
| 1760883680 | Retha D Gentry | Nurse Practitioner | 365 Stout Drive, Nicks Hall Room 160, Johnson City, TN 37614-7114 | 2014-09-10 |
| 1679889356 | Amanda S Moorhouse | Nurse Practitioner | 365 Stout Drive, Johnson City, TN 37614-1703 | 2010-08-19 |
| 1487892220 | Donna C. Fraysier | Clinical Nurse Specialist | 365 Stout Drive, Nicks Hall, Room 160, Johnson City, TN 37614 | 2009-02-02 |
| 1083750590 | Stanley Lee Ridner IIi | Nurse Practitioner | 365 Stout Drive, Suite 160, Johnson City, TN 37614 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467061887 | Jessica Marie Robinson | Pharmacist | Maple Avenue Building 7, Johnson City, TN 37614 | 2020-07-31 |
| 1881220697 | Rachel Miller Slough | Psychologist | 801 S Dossett Drive, Johnson City, TN 37614 | 2020-03-13 |
| 1326682493 | Yoshihiro Kojima | Specialist/Technologist | 127 W John Robert Bill Dr, Johnson City, TN 37614 | 2019-11-01 |
| 1205360104 | Charlotte Lynn Alexander | Student in an Organized Health Care Education/Training Program | Department of Obstetrics and Gynecology, 70569, Qcom Building 1, Room 307, Johnson City, TN 37614 | 2017-04-18 |
| 1679006787 | Joel Whipple | Student in an Organized Health Care Education/Training Program | Etsu - Building 1, 2nd Floor, Johnson City, TN 37614 | 2017-04-05 |
| 1497295711 | Charles Faust | Dental Hygienist | 1276 Gilbreath Dr, Johnson City, TN 37614 | 2017-03-06 |
| 1265889414 | Dyan Darang | Student in an Organized Health Care Education/Training Program | Etsu, Quillen College of Medicine, Psychiatry Residency Program, Box 70567, Johnson City, TN 37614 | 2016-05-18 |
| 1194170142 | Katharine Ann Lasher | Student in an Organized Health Care Education/Training Program | Dept. of Surgery, Dogwood Ave, Building 1, Rm 249, East Tennessee State Univ. Quillen College of Medicine, Johnson City, TN 37614 | 2016-04-27 |
| 1992150189 | Nishika Shina Moradia | Student in an Organized Health Care Education/Training Program | East Tennessee State University Quillen College of Medi, Dogwood Ave, Building 1, Room 249, Johnson City, TN 37614 | 2016-04-26 |
| 1962884429 | Apurva Bansal | Student in an Organized Health Care Education/Training Program | 325 North State of Franklin, Johnson City, TN 37614 | 2015-06-22 |
| Find all providers in zip 37614 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063025724 | Victoria Elizabeth Mcmanus | Nurse Practitioner | 365 Harry L Dr Ste 110, Johnson City, NY 13790-1471 | 2020-08-24 |
| 1649880139 | Amanda Danielle Ledford | Nurse Practitioner | 3 Enfield Ct, Johnson City, TN 37604-9101 | 2020-08-09 |
| 1861000135 | Deborah L Johnson | Nurse Practitioner | 2 Mcgregor Pl, Johnson City, TN 37604-1454 | 2020-07-22 |
| 1255978417 | William Mcguire | Nurse Practitioner | 176 Willocks Rd, Johnson City, TN 37601-6274 | 2019-12-06 |
| 1881248664 | Caiti Riden | Nurse Practitioner | 316 Marketplace Dr Ste 10, Johnson City, TN 37604-2595 | 2019-07-30 |
| 1699330282 | Courtney S Willis | Nurse Practitioner | 2203 N Greenwood Dr, Johnson City, TN 37604-7030 | 2019-05-08 |
| 1861955452 | Cindy Canter | Nurse Practitioner | 3552 Greenwood Dr, Johnson City, TN 37604-2834 | 2019-04-10 |
| 1366908980 | Holly Anne Parvin | Nurse Practitioner | 3209 W Walnut St, Johnson City, TN 37604-5949 | 2019-02-19 |
| 1891261376 | Lindsey Toney | Nurse Practitioner | 980 Smalling Rd, Johnson City, TN 37601-8208 | 2018-10-22 |
| 1821572868 | Karyn Kimberly Bruton | Nurse Practitioner | 1723 N Roan St, Johnson City, TN 37601-3949 | 2018-09-15 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37614 |
Please comment or provide details below to improve the information on TALISHA ETTINA LEEANN TROUTT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.