Provider Demographics
NPI:1538790985
Name:WOOLMAN, KRYSTAL TRENCHFIELD (PA-C)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:TRENCHFIELD
Last Name:WOOLMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 DOWELL SPRINGS BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2445
Mailing Address - Country:US
Mailing Address - Phone:865-346-6472
Mailing Address - Fax:865-312-8965
Practice Address - Street 1:1400 DOWELL SPRINGS BLVD STE 330
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2445
Practice Address - Country:US
Practice Address - Phone:865-346-6472
Practice Address - Fax:865-312-8965
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09880363A00000X
TN4131363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant