Individual
KELLEY DUNCAN MAYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AOCNP
Contact information
Practice address
671 HIGHWAY 58 E, NORTON, VA 24273-3007
(276) 679-5874
(276) 679-6912
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024166936
VA
363L00000X
Nurse Practitioner
APN0000006314
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100062220
—
KY
Enumeration date
07/09/2006
Last updated
12/10/2015
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