Provider Demographics
NPI:1821379413
Name:PRESSLEY, KELLI DAWN (DPH)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:DAWN
Last Name:PRESSLEY
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 ROYAL PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3706
Mailing Address - Country:US
Mailing Address - Phone:615-889-7664
Mailing Address - Fax:615-889-7841
Practice Address - Street 1:801 ROYAL PKWY STE 105
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-3706
Practice Address - Country:US
Practice Address - Phone:615-889-7664
Practice Address - Fax:615-889-7841
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist