Provider Demographics
NPI:1982387445
Name:COVENTRY, KAILEY (RN, DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:
Last Name:COVENTRY
Suffix:
Gender:F
Credentials:RN, DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 1ST AVE N UNIT 3
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-1866
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16314 NW US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-5266
Practice Address - Country:US
Practice Address - Phone:386-518-2418
Practice Address - Fax:386-961-4459
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY352548363LF0000X
FLAPRN11035704363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily