Healthcare Provider Details

I. General information

NPI: 1073375689
Provider Name (Legal Business Name): JAYLA HOLT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 DUKE ST
ASHLAND CITY TN
37015-1514
US

IV. Provider business mailing address

2500 CHARLOTTE AVE
NASHVILLE TN
37209-4129
US

V. Phone/Fax

Practice location:
  • Phone: 629-289-3136
  • Fax:
Mailing address:
  • Phone: 615-340-7781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number39706
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: