Provider Demographics
NPI:1548296668
Name:SASSER, ALICE W (DVM, MSN, PMHCNS-BC)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:W
Last Name:SASSER
Suffix:
Gender:F
Credentials:DVM, MSN, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 W ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3728
Mailing Address - Country:US
Mailing Address - Phone:865-216-3869
Mailing Address - Fax:
Practice Address - Street 1:5837 LYONS VIEW PIKE
Practice Address - Street 2:5908 LYONS VIEW PIKE
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6474
Practice Address - Country:US
Practice Address - Phone:865-216-3869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7639364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3905674Medicaid
TN3905674Medicare PIN
TN3905674Medicaid