Healthcare Provider Details

I. General information

NPI: 1477028256
Provider Name (Legal Business Name): KRISTA NIICOLE BAILEY AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRITA NICOLE BENSON

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1927 MEMORIAL BLVD
MURFREESBORO TN
37129
US

IV. Provider business mailing address

2717 E OAKLAND AVE
JOHNSON CITY TN
37601-1843
US

V. Phone/Fax

Practice location:
  • Phone: 615-904-9111
  • Fax: 931-728-1016
Mailing address:
  • Phone: 423-926-2358
  • Fax: 423-926-2680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number24900
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: