Individual
JENNIFER KIDD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
015179
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3004100
—
TN
01
—
3029971
BCBS PROVIDER NUBER
TN
05
—
64911407
—
KY
Enumeration date
06/30/2005
Last updated
07/08/2007
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