DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KELLIE LAWRENCE HENDERSON, PA

Active

KELLIE LAWRENCE HENDERSON, PA is a Medical Physician Assistant healthcare provider located in EAST RIDGE, Tennessee. NPI 1225145865 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · EAST RIDGE, TN

Registration Details

NPI Number
1225145865
Provider Type
Individual
Gender
Female
NPI Issued
Aug 23, 2006 (19.973426357516 yrs)
Last Updated
Aug 5, 2015
License
PA0000001098 (TN)

Practice Information

Address
1508 TOMBRAS AVE
EAST RIDGE, TN, 374122720
Browse TN providers · Browse ZIP 37412
Phone
4238674969
Fax
4238674971
Primary Specialty
Medical Physician Assistant
363AM0700X

Other Medical Physician Assistant Providers in EAST RIDGE, TN

Name Credential NPI
PATRICIA DIANE BLASICK PA 1003072059
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.