Healthcare Provider Details

I. General information

NPI: 1881519858
Provider Name (Legal Business Name): KAYLEE BROOKLYN WELCH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 E CENTRAL AVE
LA FOLLETTE TN
37766-2616
US

IV. Provider business mailing address

195 SHADY LN
CARYVILLE TN
37714-3725
US

V. Phone/Fax

Practice location:
  • Phone: 423-201-9799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number42711
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: