Provider Demographics
NPI:1902210628
Name:VOUTSINA-KERNY, MARIA (FNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:VOUTSINA-KERNY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 W MORRIS BLVD STE 400B
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2282
Mailing Address - Country:US
Mailing Address - Phone:423-586-2410
Mailing Address - Fax:423-581-9692
Practice Address - Street 1:420 W MORRIS BLVD STE 400B
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2282
Practice Address - Country:US
Practice Address - Phone:423-586-2410
Practice Address - Fax:423-581-9692
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000018544363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN 18544OtherST LIC