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General NPI Number Information
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NPI Number | 1184619306
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Entity Type | Individual
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Provider Name | VIRGINIA LANE KELLY CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 2121 MEDICAL CENTRE WAY SUITE 100
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City | KNOXVILLE
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State | TN
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Zip | 37920
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Country | US
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Telephone | 606-337-3051
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Fax | 606-337-2871
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Provider Business Mailing Address
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Address Line | 9000 EXECUTIVE PARK DRIVE - UPA PHYSICIANS C200
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City | KNOXVILLE
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State | TN
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Zip | 37923
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Country | US
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Telephone | 865-670-6700
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Fax | 865-670-6142
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1072826/4024A
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 14631
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License Number State | TN
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