Provider Demographics
NPI:1831728559
Name:SALYARDS, KRISTEN (NP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:SALYARDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:DICKERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:441 S ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-7510
Mailing Address - Country:US
Mailing Address - Phone:865-685-0767
Mailing Address - Fax:865-685-0097
Practice Address - Street 1:441 S ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7510
Practice Address - Country:US
Practice Address - Phone:865-685-0767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95014208363LF0000X
TN30024363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily