Healthcare Provider Details

I. General information

NPI: 1558225110
Provider Name (Legal Business Name): KAYLA ELIZABETH HARTMAN RDN, LDN, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

9019 BRIXWORTH CT
OLD HICKORY TN
37138-2963
US

IV. Provider business mailing address

9019 BRIXWORTH CT
OLD HICKORY TN
37138-2963
US

V. Phone/Fax

Practice location:
  • Phone: 606-620-8338
  • Fax:
Mailing address:
  • Phone: 606-620-8338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3998
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: