Healthcare Provider Details

I. General information

NPI: 1285545947
Provider Name (Legal Business Name): TYLER MARIE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TYLER MARIE WINFREE

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 VIRGINIA WAY STE 300
BRENTWOOD TN
37027-7611
US

IV. Provider business mailing address

114 SUTTON AVE
WAVERLY TN
37185-1850
US

V. Phone/Fax

Practice location:
  • Phone: 615-994-1000
  • Fax: 615-994-0100
Mailing address:
  • Phone: 931-209-4323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: