Healthcare Provider Details

I. General information

NPI: 1821992660
Provider Name (Legal Business Name): KELLI CRUTCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 BELLSHIRE TERRACE CT
NASHVILLE TN
37207-1739
US

IV. Provider business mailing address

1101 LAUREL ST APT 306
NASHVILLE TN
37203-4051
US

V. Phone/Fax

Practice location:
  • Phone: 615-573-3848
  • Fax:
Mailing address:
  • Phone: 615-573-3848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number257597
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: