| Ckkn, Llc | |
|
317 Seven Springs Way Brentwood TN 37027-4511 | |
| (615) 846-4558 | |
| (615) 461-1726 |
| Full Name | Ckkn, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 317 Seven Springs Way, Brentwood, Tennessee |
| Authorized Official Name and Position | Crystal Koss (CO-OWNER) |
| Authorized Official Contact | 6155070047 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ckkn, Llc 317 Seven Springs Way Brentwood TN 37027-4511 Ph: (615) 846-4558 | Ckkn, Llc 317 Seven Springs Way Brentwood TN 37027-4511 Ph: (615) 846-4558 |
| NPI Number | 1609336536 |
|---|---|
| Provider Enumeration Date | 03/25/2019 |
| Last Update Date | 04/02/2020 |
| Certification Date | 04/02/2020 |
| Medicare PECOS PAC ID | 9830427699 |
|---|---|
| Medicare Enrollment ID | O20190819001585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609336536 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Anne A Fottrell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740222538 PECOS PAC ID: 7113815564 Enrollment ID: I20040308000526 |
| Provider Name | Margo D Fortney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306027040 PECOS PAC ID: 9537216585 Enrollment ID: I20090409000357 |
| Provider Name | Temeka R Tunstall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124382643 PECOS PAC ID: 3274782115 Enrollment ID: I20121009000336 |
| Provider Name | Rachel E Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730692898 PECOS PAC ID: 0648507988 Enrollment ID: I20190809001257 |
| Provider Name | Melissa R Routh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780194860 PECOS PAC ID: 2062846918 Enrollment ID: I20191231000134 |
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