Individual
MRS. KEATA LORRAINE ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
116 W MAIN ST, HENDERSON, TN 38340-4003
(731) 989-0001
(731) 989-5151
Mailing address
116 W MAIN ST, HENDERSON, TN 38340-2231
(731) 989-0001
(731) 989-5151
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN#6159
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3908653
—
TN
01
—
4052228
BCBS
TN
01
—
621620777
TRICARE
TN
Enumeration date
05/10/2006
Last updated
03/07/2023
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