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Contact Information

KATHRYN BACKUS, NP
2033 MEADOWVIEW LN
STE 200
KINGSPORT, TN37660-7569
 Phone: 423-857-2260
 Fax: 423-857-2261
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for KATHRYN BACKUS · (Female)

NPI # 1508869348
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 05/24/2005
Last updated 08/27/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • TN License # APN 6139
  • VA License # 0024070828
  • TN Medicaid 3348978
  • TN Medicaid PENDING
  • VA Medicaid 007787031
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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