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Individual

KELLIE L MATHEWSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2030 FALLING WATERS RD STE 325, KNOXVILLE, TN 37922-5893
(865) 951-1300
Mailing address
2030 FALLING WATERS RD STE 325, KNOXVILLE, TN 37922-5893
(865) 951-1300

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
112416
TN
363L00000X
Nurse Practitioner
Primary
15629
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1523154
TN
Enumeration date
03/15/2011
Last updated
07/25/2025
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