Individual
KELSEY HORNER FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2018 CLINCH AVE, KNOXVILLE, TN 37916
(865) 541-8266
(865) 541-8553
Mailing address
PO BOX 15010, KNOXVILLE, TN 37901-5010
(865) 541-8187
(865) 541-8286
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
20848
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q049909
—
TN
Enumeration date
07/05/2016
Last updated
02/14/2025
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