Provider Demographics
NPI:1104372580
Name:HERNDON, RYLEE (FNP-C)
Entity Type:Individual
Prefix:
First Name:RYLEE
Middle Name:
Last Name:HERNDON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 JERRELL LN
Mailing Address - Street 2:
Mailing Address - City:GORDONSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38563-6563
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:333 COMMERCE ST
Practice Address - Street 2:SUITE 700
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37201-1826
Practice Address - Country:US
Practice Address - Phone:615-627-2254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000021428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily