Individual
TAMMY S KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1307 WEST AVE, SUITE 102, CROSSVILLE, TN 38555-5107
(931) 456-4433
(931) 456-4405
Mailing address
1307 WEST AVE, SUITE 102, CROSSVILLE, TN 38555-5107
(931) 456-4433
(931) 456-4405
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
106290
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106290
RN LICENSE
TN
Enumeration date
05/22/2006
Last updated
03/13/2015
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