Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 28486 | TN |
NPI | 1003417486 |
---|---|
Provider Name | Kayln Wolfe |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2020 |
Last Update Date | 25/11/2020 |