Individual
KELLY E RAWLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
205 HOSPITAL DR, SUITE A, MC KENZIE, TN 38201-1649
(731) 352-7907
(731) 352-4459
Mailing address
205 HOSPITAL DR, SUITE A, MC KENZIE, TN 38201-1649
(731) 352-7907
(731) 352-4459
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000002369
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q010586
—
TN
Enumeration date
07/25/2013
Last updated
08/26/2016
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