Provider Demographics
NPI:1316500812
Name:CHAIRES, CAITLYN MICHELLE (FNP-BC)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:MICHELLE
Last Name:CHAIRES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:MICHELLE
Other - Last Name:ROOKSTOOL CHAIRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:30 BURTON HILLS BLVD STE 175
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6403
Mailing Address - Country:US
Mailing Address - Phone:615-988-2014
Mailing Address - Fax:615-208-1303
Practice Address - Street 1:525 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4782
Practice Address - Country:US
Practice Address - Phone:865-268-4265
Practice Address - Fax:865-268-4266
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000025624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
2018081259OtherANCC