Provider Demographics
NPI:1811715048
Name:MCKAMEY, KELLY JOSEPH (FNP)
Entity type:Individual
Prefix:MR
First Name:KELLY
Middle Name:JOSEPH
Last Name:MCKAMEY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 LAKE LN
Mailing Address - Street 2:
Mailing Address - City:CARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37714-3177
Mailing Address - Country:US
Mailing Address - Phone:423-494-4558
Mailing Address - Fax:
Practice Address - Street 1:233 E EMORY RD STE 111
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-4059
Practice Address - Country:US
Practice Address - Phone:865-660-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38732146L00000X
TN231089163W00000X
TN36803363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No163W00000XNursing Service ProvidersRegistered Nurse