Provider Demographics
NPI:1821450792
Name:TUCKER, KAYLA MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:TUCKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CUMBERLAND BND
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1805
Mailing Address - Country:US
Mailing Address - Phone:615-726-3340
Mailing Address - Fax:
Practice Address - Street 1:6000 RAMSEY WAY
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2198
Practice Address - Country:US
Practice Address - Phone:615-446-3797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30069363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health