Healthcare Provider Details

I. General information

NPI: 1982310652
Provider Name (Legal Business Name): KAYLIE ELIZABETH HUDDLESTON APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 BENWOOD AVE STE B
LEXINGTON TN
38351-1444
US

IV. Provider business mailing address

129 HEDGEWOOD DR
LEXINGTON TN
38351-1332
US

V. Phone/Fax

Practice location:
  • Phone: 731-252-3326
  • Fax: 731-252-2724
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33281
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: