Individual
KAITLYN BROOKE MASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1080 NEAL ST STE 300, COOKEVILLE, TN 38501-0945
(931) 854-1391
Mailing address
5808 PAINE RD, COOKEVILLE, TN 38501-7252
(931) 644-9220
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
29199
TN
363LF0000X
Family Nurse Practitioner
Primary
29199
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29199
APRN LICENSE
TN
Enumeration date
03/19/2021
Last updated
02/19/2025
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