| Kellie Lawrence Henderson, PA | |
|
1508 Tombras Ave, East Ridge, TN 37412-2720 | |
| (423) 867-4969 | |
| (423) 867-4971 |
| Full Name | Kellie Lawrence Henderson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 1508 Tombras Ave, East Ridge, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225145865 | NPI | - | NPPES |
| 4219886 | Other | TN | BCBS- TENNESSEE |
| Q007546 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA0000001098 (Tennessee) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kellie Lawrence Henderson, PA 1508 Tombras Ave, East Ridge, TN 37412-2720 Ph: (423) 867-4969 | Kellie Lawrence Henderson, PA 1508 Tombras Ave, East Ridge, TN 37412-2720 Ph: (423) 867-4969 |
Patricia Diane Blasick, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1508 Tombras Ave, East Ridge, TN 37412 Phone: 423-867-4969 Fax: 423-867-4971 | |
Evan Mckenzie, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 403 Mcbrien Rd, East Ridge, TN 37412 Phone: 423-894-3589 |