| Positively Living, Inc. | |
|
1925 Ailor Ave Knoxville TN 37921-5804 | |
| (865) 525-1540 | |
| (856) 525-3772 |
| Full Name | Positively Living, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1925 Ailor Ave, Knoxville, Tennessee |
| Authorized Official Name and Position | Angela M Kruse (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 4236022292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Positively Living, Inc. 317 N Gay St Knoxville TN 37917-7529 Ph: (865) 525-1540 | Positively Living, Inc. 1925 Ailor Ave Knoxville TN 37921-5804 Ph: (865) 525-1540 |
| NPI Number | 1306356506 |
|---|---|
| Provider Enumeration Date | 10/03/2017 |
| Last Update Date | 06/11/2021 |
| Medicare PECOS PAC ID | 8820353634 |
|---|---|
| Medicare Enrollment ID | O20180529001085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306356506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Daniel Stewart Ely |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194744516 PECOS PAC ID: 9133027758 Enrollment ID: I20040102000674 |
| Provider Name | Marshe D Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407090889 PECOS PAC ID: 2365595469 Enrollment ID: I20090807000272 |
| Provider Name | Margaret S Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184979007 PECOS PAC ID: 4082861398 Enrollment ID: I20120821000889 |
| Provider Name | Marye Bernard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285805150 PECOS PAC ID: 7113170721 Enrollment ID: I20130110000183 |
| Provider Name | Heather N Bradner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336557917 PECOS PAC ID: 2365663143 Enrollment ID: I20141020001593 |
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