Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

East Tennessee State University

Organization Family Nurse Practitioner · NPI 1275902884

East Tennessee State University provides Family Nurse Practitioner services in Johnson City, Tennessee. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address checks out

1000 N Roan St
Johnson City, TN 37601-4616
Phone: (423) 434-5249
Fax: (423) 434-5295
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1275902884
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Betty King — Acting Chief Financial Officer · (423) 439-4414
Other names Northside Elementary School Clinic
NPI enumeratedSeptember 24, 2015
Last updated in NPPESFebruary 23, 2017
Mailing address365 Stout Drive Box 70403, Johnson City, TN 37614-1703

Other providers in Johnson City