Healthcare Provider Details

I. General information

NPI: 1255266953
Provider Name (Legal Business Name): KELLI JO OERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 STEWARTS FERRY PIKE # 1012
NASHVILLE TN
37214-3414
US

IV. Provider business mailing address

567 STEWARTS FERRY PIKE
NASHVILLE TN
37214-3414
US

V. Phone/Fax

Practice location:
  • Phone: 615-707-0876
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7792
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: