Provider Demographics
NPI:1033228804
Name:MCKELVEY, JUDY ELAINE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:ELAINE
Last Name:MCKELVEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5129 HERSCHEL SPEARS CIR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5177
Mailing Address - Country:US
Mailing Address - Phone:615-370-2978
Mailing Address - Fax:
Practice Address - Street 1:1310 24TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2637
Practice Address - Country:US
Practice Address - Phone:615-327-5390
Practice Address - Fax:615-321-6369
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000136462163W00000X
AL1-27739163W00000X
ALCRNA 046095367500000X
TNAPN APN0000010663367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse