Female

Kelli D. Tidwell FNP

Nurse Practitioner in Knoxville, TN(View on Map)

Full Name

Kelli D Tidwell FNP

NPI Number

1104074822

NPI Type

Individual Provider

Gender

Female

Enumeration Date

09/06/2008

Specialties

(Taxonomies)

Code

363L00000X

Primary Taxonomy

Yes

Licenses

State

Tennessee

License Number

APN0000007947

Contact
Information

Purpose

Mailing
Location

Address

1450 DOWELL SPRINGS BLVD
1450 DOWELL SPRINGS BLVD

City

Knoxville
Knoxville

State

TN
TN

Postal Code

37909
37909

Country

US
US

Telephone Number

(865) 637-8812
(865) 637-8812

Identifiers

Identifier

Q005786

Identifier State

TN

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/17/2021

Provider Address

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