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Contact Information

865 WELLNESS KETAMINE LLC
601 S CONCORD ST STE 100
KNOXVILLE, TN37919-3339
 Phone: 865-805-3118
 Fax: 865-415-2841
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for 865 WELLNESS KETAMINE LLC

NPI # 1912696808
LBN Legal business name 865 WELLNESS KETAMINE LLC
Authorized official JENNIFER WATSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/05/2023
Last updated 07/23/2025 - About 11 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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