Provider Demographics
NPI:1538242730
Name:ZANDSTRA, KARLYN J (PNP)
Entity type:Individual
Prefix:
First Name:KARLYN
Middle Name:J
Last Name:ZANDSTRA
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1930 ALCOA HWY
Mailing Address - Street 2:SUITE 145
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1500
Mailing Address - Country:US
Mailing Address - Phone:865-305-6650
Mailing Address - Fax:865-305-6572
Practice Address - Street 1:1930 ALCOA HWY
Practice Address - Street 2:SUITE 145
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1500
Practice Address - Country:US
Practice Address - Phone:865-305-6650
Practice Address - Fax:865-305-6572
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007465363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics