Provider Demographics
NPI:1134622418
Name:MORRISON, KELLI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7273 EMERALD HEATH RD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-4822
Mailing Address - Country:US
Mailing Address - Phone:865-382-2639
Mailing Address - Fax:865-351-5546
Practice Address - Street 1:VETERANS WAY
Practice Address - Street 2:CROSS STREET LAMONT ST
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23864363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health