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General NPI Number Information
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NPI Number | 1700455128
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Entity Type | Individual
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Provider Name | KELLI L SANDERSON
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Gender | Female
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Dates
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Enumeration Date | 06/21/2021
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 2200 21ST AVE S STE 402
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City | NASHVILLE
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State | TN
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Zip | 37212-4929
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Country | US
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Telephone | 615-292-3563
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Fax |
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Provider Business Mailing Address
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Address Line | 10214 MONTHAVEN PARK PL
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-7034
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 974
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License Number State | TN
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