Individual
HEATHER N KETRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 W STONE DR, SUITE 110, KINGSPORT, TN 37660-6027
(423) 224-3701
(423) 224-3709
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
162683
TN
363LF0000X
Family Nurse Practitioner
0024174211
VA
363LF0000X
Family Nurse Practitioner
Primary
21921
TN
Other
Enumeration date
10/13/2016
Last updated
12/19/2016
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