Healthcare Provider Details
I. General information
NPI: 1598526394
Provider Name (Legal Business Name): KATHLEEN MCINNIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/18/2024
Last Update Date: 06/09/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
740 COOL SPRINGS BLVD STE 140
FRANKLIN TN
37067-6449
US
IV. Provider business mailing address
7464 RIVER ROAD PIKE
NASHVILLE TN
37209-5729
US
V. Phone/Fax
- Phone: 615-637-1490
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WM0705X |
| Taxonomy | Medical-Surgical Registered Nurse |
| License Number | 0000233437 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 37308 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: