Provider Demographics
NPI:1285820399
Name:REESLUND, KRISTEN (PHD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:REESLUND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11101 DOCTORS' OFFICE TOWER
Mailing Address - Street 2:2200 CHILDREN'S WAY
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-9003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11101 DOCTORS' OFFICE TOWER
Practice Address - Street 2:2200 CHILDREN'S WAY
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-9003
Practice Address - Country:US
Practice Address - Phone:615-936-0249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3002103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical