Provider Demographics
NPI:1700679040
Name:CAPPS, AUDREA (LMT)
Entity type:Individual
Prefix:
First Name:AUDREA
Middle Name:
Last Name:CAPPS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:AUDREA
Other - Middle Name:LYNN
Other - Last Name:CAPPS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:1232 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:DANDRIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37725-4749
Mailing Address - Country:US
Mailing Address - Phone:865-660-9515
Mailing Address - Fax:
Practice Address - Street 1:1232 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:DANDRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37725-4749
Practice Address - Country:US
Practice Address - Phone:865-660-9515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000013803225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist