MRS. KELLY RENEA ALSUP (NPI# 1720537640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720537640 |
| Entity Type | Individual |
| Full Name | MRS. KELLY RENEA ALSUP |
| Credential | FNP-C |
| Practice Address |
250 Cherokee Professional Park Maryville TN 37804-5153 |
| Practice Telephone | 8656810103 |
| Practice Fax Number | 8652731004 |
| Mailing Telephone | 8656810103 |
| Mailing Fax Number | 8652731004 |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
21762 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609148741 | Kelly Alsup | Pharmacist | 817 Saint Andrews Rd, Columbia, SC 29210-5828 | 2012-02-06 |
| Street Address |
250 CHEROKEE PROFESSIONAL PARK |
| City | MARYVILLE |
| State | TN |
| Zip Code | 37804-5153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841209830 | Tracie A Traver | Obstetrics & Gynecology | 250 Cherokee Professional Park, Maryville, TN 37804-5153 | 2006-08-07 |
| 1073893475 | Alisa Sue Newman | Nurse Practitioner | 250 Cherokee Professional Park, Maryville, TN 37804-5153 | 2011-08-17 |
| 1164613816 | Tasheema Lanell Fair | Obstetrics & Gynecology | 250 Cherokee Professional Park, Maryville, TN 37804-5153 | 2007-08-07 |
| 1104921469 | Nancy F Garza | Obstetrics & Gynecology | 250 Cherokee Professional Park, Maryville, TN 37804-5153 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835825 | Matthew David Mallory | Physical Therapist | Morning View Village 2320 E. Lamar Alexander Parway, Maryville, TN 37804 | 2019-01-22 |
| 1063937290 | Rachel Ryan Mcmillan | Counselor | 362 High Street, Maryville, TN 37804 | 2017-08-09 |
| 1316461460 | Steven Casey Boring | Nurse Practitioner | 907 E. Lamar Alexander Pkwy., Maryville, TN 37804 | 2017-07-31 |
| 1851738751 | Robert Kane Mccall | Pathology | 250 E. Broadway, Maryville, TN 37804 | 2013-05-31 |
| 1619242849 | Jennifer Mcclements | Physical Therapy Assistant | 4004 Samuel Circle, Maryville, TN 37804 | 2012-03-21 |
| 1316223886 | Sabrina Nicole Powers | Social Worker | 1704 East Broadway, Maryville, TN 37804 | 2011-10-28 |
| 1407138381 | Russmann, Inc. | Ambulance | 4163 Benny Delozier Drive, Maryville, TN 37804 | 2011-09-15 |
| 1184932485 | Complete Family Care of Maryville, Pllc | Internal Medicine | 2004 E. Broadway, Maryville, TN 37804 | 2010-09-21 |
| 1093975096 | Kristi Clark Correll | Speech-Language Pathologist | 2030 East Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-12 |
| 1134388267 | Barbara Frantz Poulsen | Speech-Language Pathologist | 2030 E Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-04 |
| Find all providers in zip 37804 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821600693 | Tonya Ann Bosaw | Nurse Practitioner | 6812 State Route 162 Ste 204, Maryville, IL 62062-8562 | 2020-08-21 |
| 1841815701 | Samantha Mclean | Nurse Practitioner | 2005 Kirkland Blvd, Maryville, TN 37803-3600 | 2020-06-16 |
| 1477102713 | Tammy Ann Buchanon | Nurse Practitioner | 2415 Effler Rd, Maryville, TN 37803-6609 | 2019-09-10 |
| 1316500812 | Caitlyn Michelle Chaires | Nurse Practitioner | 525 W Broadway Ave, Maryville, TN 37801-4782 | 2019-04-19 |
| 1316461460 | Steven Casey Boring | Nurse Practitioner | 907 E. Lamar Alexander Pkwy., Maryville, TN 37804 | 2017-07-31 |
| 1477902708 | Katherine Buckner | Nurse Practitioner | 708 Devictor Dr, Maryville, TN 37801-8666 | 2016-06-07 |
| 1124484415 | Shannon Everett | Nurse Practitioner | 1716 Old Mount Tabor Rd, Maryville, TN 37801-7866 | 2016-01-03 |
| 1952797383 | Amanda Sue Anderson | Nurse Practitioner | 144 Oak Hill Dr, Maryville, IL 62062-6475 | 2015-04-13 |
| 1992194401 | Alyssa R. Loepker | Nurse Practitioner | 6812 State Route 162 Ste 120, Maryville, IL 62062-8586 | 2015-01-21 |
| 1477956076 | Lori B Crisp | Nurse Practitioner | 339 Bmh Physicians Office Bldg, Maryville, TN 37804-5820 | 2014-09-27 |
| Find all providers in MARYVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.