Healthcare Provider Details

I. General information

NPI: 1225945108
Provider Name (Legal Business Name): KYLEE HARMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LADD LANDING BLVD
KINGSTON TN
37763-2366
US

IV. Provider business mailing address

115 WOODY MEADOW DR
KINGSTON TN
37763-4554
US

V. Phone/Fax

Practice location:
  • Phone: 865-717-7085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49973
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: