Provider Demographics
NPI:1447841473
Name:DENT, KELSEY E (NP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:E
Last Name:DENT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MOUNTAIN VIEW DR STE A
Mailing Address - Street 2:
Mailing Address - City:KIMBALL
Mailing Address - State:TN
Mailing Address - Zip Code:37347-5478
Mailing Address - Country:US
Mailing Address - Phone:423-942-9171
Mailing Address - Fax:423-942-9128
Practice Address - Street 1:24 MOUNTAIN VIEW DR STE A
Practice Address - Street 2:
Practice Address - City:KIMBALL
Practice Address - State:TN
Practice Address - Zip Code:37347-5478
Practice Address - Country:US
Practice Address - Phone:423-942-9171
Practice Address - Fax:423-942-9128
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29142363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner