Provider Demographics
NPI:1558100149
Name:MCKEEHAN, ASHLYN JACKSON (OTD)
Entity type:Individual
Prefix:DR
First Name:ASHLYN
Middle Name:JACKSON
Last Name:MCKEEHAN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:ASHLYN
Other - Middle Name:NICOLE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90 HOWARD DR
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2929 TAZEWELL PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-1874
Practice Address - Country:US
Practice Address - Phone:865-328-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8003225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist