MRS. KELLY RENEA ALSUP FNP-C NPI 1720537640

NPI Information

  • NPI: 1720537640
  • Provider Name: MRS. KELLY RENEA ALSUP, FNP-C
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 270 BMH PHYSICIANS OFFICE BLDG
    MARYVILLE, TN
    ZIP 37804
  • Phone: (865) 546-1642

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NPI Details

MRS. Kelly Renea Alsup, FNP-C is a family nurse practitioner in Maryville, TN with 9 years of experience. MRS. Kelly Renea Alsup, FNP-C NPI is 1720537640. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

270 BMH PHYSICIANS OFFICE BLDG
MARYVILLE, TN
ZIP 37804-904
Phone: (865) 546-1642
Fax: (833) 396-2528

The NPI 1720537640 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/4/2016 and was last updated on 4/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily21762TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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