Kellie M Williamson, RN
Individual provider Active NPI Community Health Registered Nurse · Evensville, TN
NPI 1356091748 · NPPES record last updated Mar 28, 2022
Key facts
- NPI
- 1356091748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Registered Nurse 163WC1500X
- License
- 141904 (TN)
- Practice address
- 344 Eagle LN
Evensville, TN 37332-3200 - Phone
- (423) 775-7819
- Fax
- (423) 775-8078
- NPI assigned
- Mar 28, 2022
- 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 |
|---|---|---|---|
| 141904 | TN | MD | Community Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | 141904 | TN | Yes |
Addresses
Primary practice location
344 Eagle LN
Evensville, TN 37332-3200
Mailing address
344 Eagle LN
Evensville, TN 37332-3200
Phone (423) 775-7819
Other providers in Evensville, TN
- Samantha Stephens
- Corazon Olana Thurman
- Melissa Katharine Tisdale
- Kaci Elizabeth Walden
- Deborah Yvonne Williams
All providers in Evensville, TN · Community Health 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 Mar 28, 2022. 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.