Provider Demographics
NPI:1437476843
Name:KILEY, NOELLE (PMH-NP)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:KILEY
Suffix:
Gender:F
Credentials:PMH-NP
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:
Other - Last Name:DUPONT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMH-NP
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-7263
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:1020 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2494
Practice Address - Country:US
Practice Address - Phone:615-396-6620
Practice Address - Fax:615-396-6625
Is Sole Proprietor?:No
Enumeration Date:2010-04-24
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19180363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPPLIED FOROtherMAGELLEN / BCBST
TNQ014697Medicaid
TNP01536965OtherRR MEDICARE
TN103500I214Medicare PIN