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General NPI Number Information
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NPI Number | 1114439627
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Entity Type | Individual
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Provider Name | CHRISTINE LAUREL ANN KELLY FNP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 6914 OFFICE PARK CIR
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City | KNOXVILLE
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State | TN
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Zip | 37909-1161
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Country | US
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Telephone | 865-200-8364
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Fax |
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Provider Business Mailing Address
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Address Line | 598 JOHN DEERE DR
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City | MAYNARDVILLE
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State | TN
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Zip | 37807-3212
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Country | US
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Telephone | 865-745-1615
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Fax |
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 216070
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 25262
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 117266
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 27740
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License Number State | TN
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