Provider Demographics
NPI:1457767345
Name:VOELKER, KACEY Q (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KACEY
Middle Name:Q
Last Name:VOELKER
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:KACEY
Other - Middle Name:Q
Other - Last Name:ROACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:420 W MORRIS BLVD
Mailing Address - Street 2:SUITE 400G
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2283
Mailing Address - Country:US
Mailing Address - Phone:423-581-2660
Mailing Address - Fax:423-581-2538
Practice Address - Street 1:420 W MORRIS BLVD
Practice Address - Street 2:SUITE 400G
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2283
Practice Address - Country:US
Practice Address - Phone:423-581-5925
Practice Address - Fax:423-581-2828
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN182891163W00000X
TN18815363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ009105Medicaid
TNQ009105Medicaid