Basic Information
| Provider Information | |||||||||
| NPI: | 1104391580 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMSEY | ||||||||
| FirstName: | KELLI | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1258 | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 384851258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9312531110 | ||||||||
| FaxNumber: | 2566644280 | ||||||||
| Practice Location | |||||||||
| Address1: | 506 N 12TH ST STE A | ||||||||
| Address2: | |||||||||
| City: | MURRAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420711660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708732022 | ||||||||
| FaxNumber: | 2708732032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2018 | ||||||||
| LastUpdateDate: | 05/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 3012694 | KY | N | Allopathic & Osteopathic Physicians | Family Medicine | 363LF0000X | 3012694 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | APN0000025328 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | APN0000025328 | 01 | TN | APRN TN LICENSE | OTHER | 3012694 | 01 | KY | APRN | OTHER | F08180115 | 01 | AANP | OTHER |