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

LicenseStateTypeSpecialty
RN0000048785TNMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Blountville, TN

All providers in Blountville, TN · Registered Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.