Provider Demographics
NPI:1437131182
Name:LILLY, KATHRYN M (APRN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:LILLY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL-50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:STE 803
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-386-3395
Practice Address - Fax:615-386-2197
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2008-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNRN123204207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7646540OtherAETNA
TN3928044Medicaid
TN4159432OtherBCBS OF TN
TN39280441OtherMEDICARE
Q02475Medicare UPIN
TN4159432OtherBCBS OF TN