MEDICARE: KAYLA ASHLEY WEST PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	000200650	TN
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	23237	TN

General Provider Information

NPI Number	:	1588181861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA ASHLEY WEST PMHNP

Provider Business Mailing Address
First Line	:	223 MADISON ST
Second Line	:	STE 103
City	:	MADISON
State	:	TN
Zip	:	37115-3660
Country	:	US
Telephone Number	:	423-282-1480
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 MADISON ST STE 103
Second Line	:
City	:	MADISON
State	:	TN
Zip	:	37115-3660
Country	:	US
Telephone Number	:	615-860-0808
Fax Number	:	615-860-0809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2017
Last Update Date	:	05/10/2019

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