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Individual

MS. KELLIE DIANNE AZOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP-C

Contact information

Practice address
195 WHITE OAK RD STE 400, DAYTON, TN 37321-2238
(423) 778-5661
Mailing address
4922 MCDONALD RD, MC DONALD, TN 37353-4057
(615) 812-1687

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
37247
TN
363LG0600X
Gerontology Nurse Practitioner
37247
TN

Other

Enumeration date
11/20/2024
Last updated
11/20/2024
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