Kellye Watkins Wilson, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH00002692 Issued in TN

Practice address

420 S. Charles Seivers Blvd
Clinton, TN 37716

Phone

(865) 457-1496

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1730650870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 DUTCH VALLEY RD",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377165406",
            "telephone_number": "865-254-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S. CHARLES SEIVERS BLVD",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "37716",
            "telephone_number": "865-457-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KELLYE",
        "middle_name": "WATKINS",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TN",
            "license": "DH00002692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Kay Webb, LPN
• Jenny Elizabeth Welch, FNP-BC
• Karen R Whalen, APRN, BC
• Nicka S. Wheat, COTA
• Wesley Whisenant, DDS
• Melissa Jane Wilson, NP
• Elizabeth Ann Wishart, FNP-BC
• Woodland Post Acute LLC
• Samantha Michelle Woods, BSN, RN
• Mollie Katherine Wright, PHARM. D.

• Dental Hygienist in Clinton, TN
• Providers in Clinton, TN by specialty
• Dental Hygienist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.