Individual
SAMANTHA CAITLIN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3443 DICKERSON PIKE STE 680, NASHVILLE, TN 37207
(615) 865-3322
Mailing address
523A W HOLLIS CHAPEL RD, PORTLAND, TN 37148-5348
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
198215
TN
363LA2100X
Acute Care Nurse Practitioner
Primary
24559
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100550900
—
KY
05
—
Q044832
—
TN
Enumeration date
06/21/2018
Last updated
01/09/2019
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