Individual
RESHONDA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1048 BLAIRFIELD DR, ANTIOCH, TN 37013-3900
(615) 979-3083
Mailing address
1048 BLAIRFIELD DR, ANTIOCH, TN 37013-3900
(615) 979-3083
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
183448
TN
343800000X
Secured Medical Transport (VAN)
Primary
183448
TN
343900000X
Non-emergency Medical Transport (VAN)
183448
TN
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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