Provider Demographics
NPI:1780083469
Name:BENDER, KAYLAN (ATC)
Entity type:Individual
Prefix:
First Name:KAYLAN
Middle Name:
Last Name:BENDER
Suffix:
Gender:
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5002 CROSSINGS CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-8471
Mailing Address - Country:US
Mailing Address - Phone:615-773-2710
Mailing Address - Fax:
Practice Address - Street 1:2000 EDGEHILL AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2116
Practice Address - Country:US
Practice Address - Phone:615-406-5346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002309-12255A2300X
TN2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer