MEDICARE: KRISTIN VANAMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist		TN

General Provider Information

NPI Number	:	1497603534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN VANAMAN

Provider Business Mailing Address
First Line	:	90 HOWARD DR
Second Line	:
City	:	SHELBYVILLE
State	:	KY
Zip	:	40065-8138
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2937 TAZEWELL PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1874
Country	:	US
Telephone Number	:	865-328-7370
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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