Provider Demographics
NPI:1295084028
Name:LENIHAN, KELSEY DAWSON (NP)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:DAWSON
Last Name:LENIHAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 PARKSIDE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1922
Mailing Address - Country:US
Mailing Address - Phone:865-218-6222
Mailing Address - Fax:
Practice Address - Street 1:10800 PARKSIDE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1922
Practice Address - Country:US
Practice Address - Phone:865-323-9763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15871363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health