Provider Demographics
NPI:1043240724
Name:YAGER, TAMI JO (FNP)
Entity type:Individual
Prefix:MS
First Name:TAMI
Middle Name:JO
Last Name:YAGER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:TAMI
Other - Middle Name:JO
Other - Last Name:KHASHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:704 LADERA CIR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-4112
Mailing Address - Country:US
Mailing Address - Phone:865-387-8702
Mailing Address - Fax:865-392-1491
Practice Address - Street 1:704 LADERA CIR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-4112
Practice Address - Country:US
Practice Address - Phone:865-387-8702
Practice Address - Fax:865-392-1491
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6240363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4031513OtherBLUE CROSS
TN3905853Medicare ID - Type Unspecified