Provider Demographics
NPI:1689708224
Name:KEE, TERESA DIANE (NP)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:DIANE
Last Name:KEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:131 SAUNDERSVILLE ROAD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075
Mailing Address - Country:US
Mailing Address - Phone:901-203-2901
Mailing Address - Fax:901-779-6968
Practice Address - Street 1:160 W UNIVERSITY PKWY STE C
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1667
Practice Address - Country:US
Practice Address - Phone:731-660-5116
Practice Address - Fax:731-660-5119
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN129471363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN129471OtherSTATE LICENSE
MB0796295OtherFEDERAL DEA CERTIFICATE
MB0796295OtherFEDERAL DEA CERTIFICATE