Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lisa Marie Ketchem, FNP-C

Individual provider Family Nurse Practitioner · NPI 1871058263

Lisa Marie Ketchem, FNP-C is a Nurse Practitioner in Kingsport, Tennessee. Qualified in 2018, 8 years ago. Practices with Tri-Cities Regional Emergency Physicians, PC, a 118-clinician group and accepts Medicare assignment. Licensed in Tennessee and Virginia.

Years since qualifying
8
Licensed in
TN, VA
In the registry since
2019
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

5039 Andrew St
Kingsport, TN 37660-6500
Phone: (423) 817-8615
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 25202 (TN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 0024184785 (VA)

Record details

NPI number1871058263
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedFebruary 10, 2019
Last updated in NPPESOctober 18, 2022
Certification dateOctober 18, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Tri-Cities Regional Emergency Physicians, Pc — 118 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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