Provider Demographics
NPI:1790344216
Name:CAGLE, BRETT AARON (NP)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:AARON
Last Name:CAGLE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 BLUEGRASS LN
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:TN
Mailing Address - Zip Code:37327-3759
Mailing Address - Country:US
Mailing Address - Phone:423-827-5970
Mailing Address - Fax:
Practice Address - Street 1:65 BLUEGRASS LN
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:TN
Practice Address - Zip Code:37327-3759
Practice Address - Country:US
Practice Address - Phone:423-827-5970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-08
Last Update Date:2019-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25160363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner