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Individual

KACI L GARRETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
758 S WILLOW AVE, COOKEVILLE, TN 38501-3840
(931) 526-6173
(931) 526-5084
Mailing address
758 S WILLOW AVE, COOKEVILLE, TN 38501-3840
(931) 526-6173
(931) 526-5084

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
11690
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20051011
PEDS NURSING CERTIFICATIO
TN
01
APN0000011690
STATE LICENSE CERTIFICATE
TN
Enumeration date
11/14/2005
Last updated
03/07/2023
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