Provider Demographics
NPI:1952851784
Name:SPITLER, KATELYN (CRNP)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:SPITLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:MICHELLE
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:444 CLINCHFIELD ST STE 201
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3863
Mailing Address - Country:US
Mailing Address - Phone:423-230-2100
Mailing Address - Fax:423-230-2112
Practice Address - Street 1:210 WESTWOOD PL STE 110
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7554
Practice Address - Country:US
Practice Address - Phone:615-206-2462
Practice Address - Fax:833-983-2043
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23079363L00000X
AL1-130379363LG0600X
VA0024175199363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology