Melody Gilliam, R.N.

Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · New Tazewell, TN

NPI 1104298116 · NPPES record last updated Oct 29, 2015

Key facts

NPI
1104298116
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Registered Nurse 163WP0808X
License
RN200435 (TN)
Practice address
1596 Highway 33 S
New Tazewell, TN 37825-7104
Phone
(423) 626-8271
Fax
(865) 342-0106
NPI assigned
Oct 29, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN200435TNMDPsychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN200435 TN Yes

Addresses

Primary practice location

1596 Highway 33 S
New Tazewell, TN 37825-7104

Mailing address

6350 W Andrew Johnson Hwy
Department 100
Talbott, TN 37877-8605
Phone (800) 355-3565

Other names

  • Melody Ann Laws Former name

Other providers in New Tazewell, TN

All providers in New Tazewell, TN · Psychiatric/Mental Health Registered Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.