Provider Demographics
NPI:1104391580
Name:RAMSEY, KELLI (APRN)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:RAMSEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1258
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-1258
Mailing Address - Country:US
Mailing Address - Phone:931-253-1110
Mailing Address - Fax:256-664-4280
Practice Address - Street 1:506 N 12TH ST STE A
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-1660
Practice Address - Country:US
Practice Address - Phone:270-873-2022
Practice Address - Fax:270-873-2032
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000025328363L00000X
KY3012694363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
F08180115OtherAANP
KY3012694OtherAPRN
TNAPN0000025328OtherAPRN TN LICENSE