Individual
KEELIE PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4160 OCOEE ST N STE 8, CLEVELAND, TN 37312-4886
(423) 464-4357
Mailing address
280 SHADY HOLLOW CIR SE, CLEVELAND, TN 37323-7742
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
260676
TN
Other
Enumeration date
10/26/2023
Last updated
09/30/2024
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