Kelley, Samantha Caitlin

Kelley, Samantha Caitlin is an individual health care provider with primary practice located at 3443 Dickerson Pike Ste 680 , Nashville TN 37207. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Emergency, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Kelley, Samantha Caitlin can be contacted via phone (615) 865-3322.

Contact Information

Primary practice address
3443 Dickerson Pike Ste 680 Nashville TN 37207
Phone: (615) 865-3322
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Emergency 163WE0003X 198215 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 24559 Tennessee

Profile Details

NPI number 1265926208
LBN Legal business name Kelley, Samantha Caitlin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2018
Last updated Jan 9th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265926208 NPPES
Kentucky MEDICAID 7100550900
Kentucky MEDICAID Q044832

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