Individual
KELLY K IDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3103 BUSINESS PARK CIR STE 100, GOODLETTSVILLE, TN 37072-3676
(615) 851-7865
(615) 851-7853
Mailing address
3103 BUSINESS PARK CIR STE 100, GOODLETTSVILLE, TN 37072-3676
(615) 851-7865
(615) 851-7853
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APN6529
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1517377
—
TN
Enumeration date
02/18/2010
Last updated
03/21/2022
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