Provider Demographics
NPI:1831633007
Name:IZZI, KRISTINE DEANNA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:DEANNA
Last Name:IZZI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 WESTGATE CIR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8075
Mailing Address - Country:US
Mailing Address - Phone:615-496-7010
Mailing Address - Fax:
Practice Address - Street 1:1607 WESTGATE CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8075
Practice Address - Country:US
Practice Address - Phone:615-376-8195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily