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Illuminate Ketamine Center Pllc
Certified Registered Nurse Anesthetist in Kingsport, Tennessee
NPI 1649833062

Illuminate Ketamine Center Pllc is a Certified Registered Nurse Anesthetist based in Kingsport, TN. Illuminate Ketamine Center Pllc practices in Kingsport, TN. The NPI Number for Illuminate Ketamine Center Pllc is 1649833062 and holds a License No. (Tennessee).

The current practice location address for Illuminate Ketamine Center Pllc is 1936 Brookside Dr Ste E, Kingsport, TN and can be reached out via phone at 423-765-0777.

Location: 1936 Brookside Dr Ste E, Kingsport, TN, 37660-4654
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1649833062
Provider Name
Illuminate Ketamine Center Pllc
Credential
Provider Entity Type
Organization
Address
1936 Brookside Dr Ste E, Kingsport, TN, 37660-4654
Phone Number
423-765-0777
Fax Number
Provider Enumeration Date
04/22/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1936 Brookside Dr Ste E
City
Kingsport
State
Tennessee
Zip
37660-4654
Phone Number
423-765-0777
Fax Number
person
Provider Business Mailing Address Details
Address
1936 Brookside Dr Ste E
City
Kingsport
State
Tennessee
Zip
37660-4654
Phone Number
423-765-0777
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Marriage & Family Therapist
Speciality
-
Taxonomy
106H00000X
License No.
()
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Infusion Therapy
Taxonomy
261QI0500X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Anesthetist, Certified Registered
Speciality
-
Taxonomy
367500000X
License No.
()
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
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