Provider Demographics
NPI:1538836325
Name:HASTEY-WITT, KERRY LYNN (APRN)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:LYNN
Last Name:HASTEY-WITT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26194
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2012
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:833-908-0998
Practice Address - Street 1:11808 KINGSTON PIKE STE 160
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3838
Practice Address - Country:US
Practice Address - Phone:865-966-3940
Practice Address - Fax:833-908-2099
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN29315363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care