NPI 1225145865

Kellie Lawrence Henderson, PA

Practitioner Medical Physician Assistant East Ridge, TN

Practice location

Address: 1508 Tombras Ave, East Ridge, TN 37412-2720
Phone: (423) 867-4969
Fax: (423) 867-4971

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence PA0000001098 (TN)

Other Physician Assistant providers in Tennessee →

Registry record

NPI: 1225145865
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Aug 2006
Record last updated: 5 Aug 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.