Healthcare Provider Details

I. General information

NPI: 1477981868
Provider Name (Legal Business Name): KAYLA ELAINE CRYE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA ELAINE TULLOCH NP

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11616 CHAPMAN HIGHWAY EAST TN CHILDREN'S HOSPITAL SEYMOUR PEDIATRICS
SEYMOUR TN
37865-3665
US

IV. Provider business mailing address

PO BOX 15004
KNOXVILLE TN
37901-5004
US

V. Phone/Fax

Practice location:
  • Phone: 865-579-7320
  • Fax: 865-406-8173
Mailing address:
  • Phone: 865-541-8895
  • Fax: 865-633-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number22775
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: