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NPI Code Detail

MEDICARE: KILE FNP HEALTHCARE LLC

MEDICARE: KILE FNP HEALTHCARE LLC
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
1363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1750627030
Entity Type Code : Organization
Provider Name (Legal Business Name) : KILE FNP HEALTHCARE LLC
Provider Business Mailing Address
First Line : PO BOX 6123
Second Line :
City : OAK RIDGE
State : TN
Zip : 37831-3969
Country : US
Telephone Number : 865-850-4673
Fax Number :
Provider Business Practice Location Address
First Line : 220 LONGMIRE RD
Second Line :
City : CLINTON
State : TN
Zip : 37716-7338
Country : US
Telephone Number : 865-457-6925
Fax Number :
Authorized Official
Title or Position : FNP
Name : NANCY KILE
Credential : FNP
Telephone Number : 865-850-4673
Provider Enumeration Date : 12/14/2012
Last Update Date : 06/03/2014

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