Healthcare Provider Details

I. General information

NPI: 1447491014
Provider Name (Legal Business Name): KATIE AGEE SEAL N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 W HIGH ST
LEBANON TN
37087-2234
US

IV. Provider business mailing address

308 W HIGH ST
LEBANON TN
37087-2234
US

V. Phone/Fax

Practice location:
  • Phone: 615-547-5993
  • Fax: 615-547-7307
Mailing address:
  • Phone: 615-547-5993
  • Fax: 615-547-7307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12669
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: