Healthcare Provider Details

I. General information

NPI: 1629987821
Provider Name (Legal Business Name): JUDITH ANN KIRKLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 CEDAR ST
SEVIERVILLE TN
37862-3803
US

IV. Provider business mailing address

3314 MCCURRY RD
KNOXVILLE TN
37924-1152
US

V. Phone/Fax

Practice location:
  • Phone: 866-453-1036
  • Fax:
Mailing address:
  • Phone: 866-453-1036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9329
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: