Provider Demographics
NPI:1235886755
Name:DEDMAN, KAYLA LANEE
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:LANEE
Last Name:DEDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:KAYLA
Other - Middle Name:LANEE
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1259 INVERNESS PASS
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087
Mailing Address - Country:US
Mailing Address - Phone:615-840-1457
Mailing Address - Fax:
Practice Address - Street 1:204 OAK ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3334
Practice Address - Country:US
Practice Address - Phone:615-840-1457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31150363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily