Individual
REGINA LEIGH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
121 S DIXIE AVE, COOKEVILLE, TN 38501-3401
(931) 528-2531
Mailing address
121 S DIXIE AVE, COOKEVILLE, TN 38501-3401
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0000154553
TN
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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