Provider Demographics
NPI:1417283987
Name:TALLEY, RAE DANIELLE (FNP)
Entity Type:Individual
Prefix:
First Name:RAE
Middle Name:DANIELLE
Last Name:TALLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RAE
Other - Middle Name:DANIELLE
Other - Last Name:PALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2400 PATTERSON ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1562
Mailing Address - Country:US
Mailing Address - Phone:615-342-5900
Mailing Address - Fax:
Practice Address - Street 1:2400 PATTERSON ST
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1562
Practice Address - Country:US
Practice Address - Phone:615-342-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14360363LF0000X
TNAPN14360363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily