Kisha A Barclay, L.P.N.
Individual provider Active NPI Licensed Practical Nurse · Chattanooga, TN
NPI 1104012863 · NPPES record last updated Sep 17, 2007
Key facts
- NPI
- 1104012863
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 65139 (TN)
- Practice address
- 413 Spring St
Chattanooga, TN 37405-3848 - Phone
- (423) 756-2740
- NPI assigned
- Sep 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65139 | TN | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Volunteer Behavioral Health Care System | Past |
Accepting new patients | |
| Volunteer Behavioral Health Care System | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/vbhcs/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 65139 | TN | Yes |
Addresses
Primary practice location
413 Spring St
Chattanooga, TN 37405-3848
Mailing address
263 Meadow Green LN Apt a
Gordonsville, TN 38563-6594
Other providers in Chattanooga, TN
- Philip A Bannor
- Kelli Ruth Banther
- Lacey Banther
- Ashlee Barber
- Brittany Sharp Barber
- Upasana Bardhan Chakraborty
- James B Bardoner
- Pamela Marie Bare
- Swarna K Bareddy
- Venkata R Bareddy
All providers in Chattanooga, TN · Licensed Practical Nurse in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.