Kassidy Nichole Foley, RN

Individual provider Active NPI Community Health Registered Nurse · Mountain City, TN

NPI 1902492044 · NPPES record last updated Dec 14, 2020

Key facts

NPI
1902492044
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
242859 (TN)
Practice address
715 W Main St
Mountain City, TN 37683-1217
Phone
(423) 727-9731
Fax
(423) 727-4153
NPI assigned
Dec 14, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
242859TNMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
State of Tennessee Past
since Dec 16, 2020
Accepting new patients
State of Tennessee Past
since Dec 16, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 242859 TN Yes

Addresses

Primary practice location

715 W Main St
Mountain City, TN 37683-1217

Mailing address

715 W Main St
Mountain City, TN 37683-1217
Phone (423) 727-9731

Other names

  • Kassidy Sutherland Other name

Other providers in Mountain City, TN

All providers in Mountain City, TN · Community Health Registered Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.