Individual
KELSEY B DEVAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
121 BOONE RIDGE DR STE 1004, JOHNSON CITY, TN 37615-4993
(423) 794-5988
(423) 232-8583
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-5988
(423) 232-8583
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
29146
TN
363LF0000X
Family Nurse Practitioner
Primary
29146
TN
Other
Enumeration date
03/03/2021
Last updated
02/19/2025
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