Healthcare Provider Details

I. General information

NPI: 1780052803
Provider Name (Legal Business Name): KAYLEIGH HOLTHAUS CNM, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2015
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9160 CAROTHERS PKWY STE 201
FRANKLIN TN
37067-6698
US

IV. Provider business mailing address

PO BOX 638985
CINCINNATI OH
45263-8985
US

V. Phone/Fax

Practice location:
  • Phone: 615-721-6250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209013328
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: