Individual
SHELLY RICHARDS KETRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2050 MEADOWVIEW PKWY, KINGSPORT, TN 37660-7475
(423) 230-5000
(423) 390-6852
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03974
NC
363A00000X
Physician Assistant
Primary
2998
TN
Other
Enumeration date
12/20/2012
Last updated
02/01/2024
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