Provider Demographics
NPI:1881205136
Name:O'BRIEN, KYLA (CNM)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 COATSLAND DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3948
Mailing Address - Country:US
Mailing Address - Phone:731-422-4642
Mailing Address - Fax:731-422-2277
Practice Address - Street 1:244 COATSLAND DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3948
Practice Address - Country:US
Practice Address - Phone:731-422-4642
Practice Address - Fax:731-422-2277
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCNM06176367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife