Individual
KEVIN O'REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 ELLIS AVE, MARYVILLE, TN 37804-5823
(865) 980-5377
(865) 980-5376
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
24725
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q044395
—
TN
Enumeration date
09/20/2018
Last updated
10/29/2025
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