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Individual

MRS. KELLY BORDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
100 LANTANA RD STE 202, CROSSVILLE, TN 38555-1903
(931) 484-5141
(865) 374-2074
Mailing address
5801 CROSSINGS BLVD, ANTIOCH, TN 37013-3130
(615) 851-9401

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
18301
TN
363LF0000X
Family Nurse Practitioner
18301
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q012706
TN
Enumeration date
02/13/2014
Last updated
11/02/2022
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