MEDICARE: KATHRYN KYLE DAILEADER AGPCNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	AC002373	MD

General Provider Information

NPI Number	:	1770060550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN KYLE DAILEADER AGPCNP-C

Provider Business Mailing Address
First Line	:	210 ATHENS WAY STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1308
Country	:	US
Telephone Number	:	703-283-7782
Fax Number	:	833-972-1856

Provider Business Practice Location Address
First Line	:	210 ATHENS WAY STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1308
Country	:	US
Telephone Number	:	833-633-1290
Fax Number	:	833-972-1856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2018
Last Update Date	:	02/04/2026

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