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General NPI Number Information
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NPI Number | 1053711689
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Entity Type | Individual
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Provider Name | REAGAN KITTS FNP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 07/29/2019
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Provider Practice Location Address
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Address Line | 8731 RUTLEDGE PIKE
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City | RUTLEDGE
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State | TN
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Zip | 37861-3112
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Country | US
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Telephone | 865-828-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 6328 MCMILLAN CREEK DR
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City | KNOXVILLE
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State | TN
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Zip | 37924-5504
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Country | US
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Telephone | 423-991-4915
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Fax | 423-374-1217
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 18784
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License Number State | TN
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