Provider Demographics
NPI:1982310652
Name:HUDDLESTON, KAYLIE ELIZABETH (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KAYLIE
Middle Name:ELIZABETH
Last Name:HUDDLESTON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 HEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-1332
Mailing Address - Country:US
Mailing Address - Phone:731-307-9780
Mailing Address - Fax:
Practice Address - Street 1:364 TENNESSEE AVE S
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-2524
Practice Address - Country:US
Practice Address - Phone:731-847-6396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily