Provider Demographics
NPI:1477959609
Name:WHITEHEAD, KYLI RIEHL (C-PNP)
Entity Type:Individual
Prefix:
First Name:KYLI
Middle Name:RIEHL
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:C-PNP
Other - Prefix:
Other - First Name:KYLI
Other - Middle Name:
Other - Last Name:RIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5550 FRANKLIN PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-2140
Mailing Address - Country:US
Mailing Address - Phone:615-749-6252
Mailing Address - Fax:833-941-2265
Practice Address - Street 1:5550 FRANKLIN PIKE STE 101
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-2140
Practice Address - Country:US
Practice Address - Phone:615-749-6252
Practice Address - Fax:833-941-2265
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000019324363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ009532Medicaid