Provider Demographics
NPI:1497008866
Name:CARRIGAN-FITE, KERRY LYNN
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:LYNN
Last Name:CARRIGAN-FITE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KERRY
Other - Middle Name:LYNN
Other - Last Name:CARRIGAN-FITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3511 OLD CLARKSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:JOELTON
Mailing Address - State:TN
Mailing Address - Zip Code:37080-8892
Mailing Address - Country:US
Mailing Address - Phone:615-299-5341
Mailing Address - Fax:
Practice Address - Street 1:3511 OLD CLARKSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:JOELTON
Practice Address - State:TN
Practice Address - Zip Code:37080-8892
Practice Address - Country:US
Practice Address - Phone:615-299-5341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN142437163W00000X, 363L00000X
TN15964363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily