Provider Demographics
NPI:1891516464
Name:KILLINGSWORTH, JANELLA KRISTEN (DNP, FNP-C, RN, CWCN)
Entity type:Individual
Prefix:
First Name:JANELLA
Middle Name:KRISTEN
Last Name:KILLINGSWORTH
Suffix:
Gender:F
Credentials:DNP, FNP-C, RN, CWCN
Other - Prefix:
Other - First Name:JANELLA
Other - Middle Name:KRISTEN
Other - Last Name:WILCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2253 CHAMBLISS AVE NW STE 101
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3861
Mailing Address - Country:US
Mailing Address - Phone:423-473-7475
Mailing Address - Fax:
Practice Address - Street 1:2253 CHAMBLISS AVE NW STE 101
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3861
Practice Address - Country:US
Practice Address - Phone:423-473-7475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily