Judy K Kinkead, RN
Individual provider Active NPI Registered Nurse · Blountville, TN
NPI 1124159629 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1124159629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN0000048785 (TN)
- Practice address
- 154 Blountville Bypass
Blountville, TN 37617-0630 - Phone
- (423) 279-2777
- Fax
- (423) 279-2797
- NPI assigned
- Mar 8, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| RN0000048785 | TN | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN0000048785 | TN | Yes |
Addresses
Primary practice location
154 Blountville Bypass
Blountville, TN 37617-0630
Mailing address
PO Box 630
Blountville, TN 37617-0630
Phone (423) 279-2777
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All providers in Blountville, TN · Registered 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 Jul 9, 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.