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General NPI Number Information
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NPI Number | 1710642558
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Entity Type | Individual
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Provider Name | JODY GLENN KITTLE MSN, APRN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/06/2021
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 1909 MALLORY LN STE 200
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City | FRANKLIN
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State | TN
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Zip | 37067-2842
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Country | US
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Telephone | 615-771-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 OAKLEAF CT
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City | FRANKLIN
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State | TN
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Zip | 37064-7409
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Country | US
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Telephone | 615-974-3103
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 32758
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 239979
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License Number State | TN
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