MEDICARE: KELLY ARYAH KITABCHI APN

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	106899	TN

General Provider Information

NPI Number	:	1699811497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY ARYAH KITABCHI APN

Provider Business Mailing Address
First Line	:	8110 N BROTHER BLVD STE 200
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38133-2760
Country	:	US
Telephone Number	:	901-255-5221
Fax Number	:	901-373-4511

Provider Business Practice Location Address
First Line	:	6745 WOLF RIVER BLVD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-2386
Country	:	US
Telephone Number	:	901-767-8442
Fax Number	:	901-684-6260

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	03/07/2025

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