Provider Demographics
NPI:1427007079
Name:KILE, NANCY (FNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:KILE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KILE
Other - Middle Name:FNP
Other - Last Name:HEALTHCARE, LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6123
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37831-3969
Mailing Address - Country:US
Mailing Address - Phone:865-850-4673
Mailing Address - Fax:
Practice Address - Street 1:100 ELMHURST DR
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7621
Practice Address - Country:US
Practice Address - Phone:865-481-3367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 05760363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3343757Medicare ID - Type Unspecified