Individual
AUDREY A KALBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
450 COLLEGE ST, NEWPORT, TN 37821-3752
(800) 632-6074
(866) 341-7509
Mailing address
PO BOX 10414, LARGO, FL 33773-0414
(800) 632-6074
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
APN0000006141
TN
363L00000X
Nurse Practitioner
Primary
RN0000072908
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36488471
—
TN
01
—
4100522
BCBS
TN
01
—
P00229948
RAILROAD MEDICARE
TN
Enumeration date
09/25/2006
Last updated
06/24/2008
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