Basic Information
Provider Information
NPI: 1194383513
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SUNDAY
FirstName: KAYLIE
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2620 ELM HILL PIKE
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372143108
CountryCode: US
TelephoneNumber: 6154254277
FaxNumber:  
Practice Location
Address1: 3054 COLUMBIA AVE
Address2:  
City: FRANKLIN
State: TN
PostalCode: 370647424
CountryCode: US
TelephoneNumber: 6183847971
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/31/2019
LastUpdateDate: 08/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPN0000025823TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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