Provider Demographics
NPI:1184123382
Name:MCKINNEY, ASHLEY (ANP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 SPRINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BEAN STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37708-3003
Mailing Address - Country:US
Mailing Address - Phone:423-312-2815
Mailing Address - Fax:
Practice Address - Street 1:290 SPRINGWOOD DR
Practice Address - Street 2:
Practice Address - City:BEAN STATION
Practice Address - State:TN
Practice Address - Zip Code:37708-3003
Practice Address - Country:US
Practice Address - Phone:423-312-2815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-03
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN194648163WC0200X
TN27355363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine