Individual
KELLEY J SHARP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
207 E RICKERT AVE, DICKSON, TN 37055-1333
(615) 260-5589
(615) 446-0259
Mailing address
207 E RICKERT AVE, DICKSON, TN 37055-1333
(615) 260-5589
(615) 446-0259
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APN6660
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4058108
BLUE CROSS BLUE SHIELD TN
TN
01
—
500014527
RAILROAD MEDICARE PIN
—
05
—
Q081360
—
TN
Enumeration date
05/24/2005
Last updated
03/22/2024
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