Kelly, Jaan

Kelly, Jaan is an individual health care provider with primary practice located at 9330 Park West Blvd Suite 202, Knoxville TN 37923-4308. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Kelly, Jaan can be contacted via phone (865) 691-4850.

Contact Information

Primary practice address
9330 Park West Blvd Suite 202 Knoxville TN 37923-4308
Phone: (865) 691-4850
Fax: (865) 694-8018
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1072 Tennessee

Profile Details

NPI number 1831189190
LBN Legal business name Kelly, Jaan
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Dec 9th, 2010 - about 15 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 1831189190 NPPES
Tennessee MEDICAID 3661893

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