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General NPI Number Information
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NPI Number | 1336785203
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Entity Type | Individual
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Provider Name | KELLY MARULANDA FNP
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Gender | Female
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 04/28/2020
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Provider Practice Location Address
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Address Line | 10710 MURDOCK DR STE 103
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City | KNOXVILLE
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State | TN
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Zip | 37932-3257
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Country | US
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Telephone | 865-690-3737
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Fax | 865-690-3757
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Provider Business Mailing Address
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Address Line | 1805 BLUE SPRING LN
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City | KNOXVILLE
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State | TN
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Zip | 37932-2002
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 27349
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License Number State | TN
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