Kaylee Breanne Nicholson

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

230562 Issued in TN

Practice address

101 Okolona Dr
Erwin, TN 37650-1387

Phone

(423) 743-9103

NPI assigned

Sep 24, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kaylee Breanne Nicholson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1174007355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 OKOLONA DR",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501387",
            "telephone_number": "423-743-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OKOLONA DR",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501387",
            "telephone_number": "423-743-9103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1036 7th St",
            "address_purpose": "LOCATION",
            "city": "Erwin",
            "state": "TN",
            "postal_code": "376501454",
            "country_code": "US",
            "telephone_number": "423-388-9563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "KAYLEE",
        "middle_name": "BREANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TN",
            "license": "230562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLEE",
            "last_name": "NICHOLSON",
            "middle_name": "BREANNE",
            "prefix": "MS.",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mountain States Health Alliance
• Mountain States Health Alliance
• Mountain States Health Alliance
• MPC
• Jessica Elam Murray, BSW
• Nolachucky Medical
• Sara Jean O'Daniel, DMD
• Victoria Lynn Osborne, F.N.P.
• Amy M Perkins, PHARMD
• Peterson Family Healthcare

• Community Health Registered Nurse in Erwin, TN
• Providers in Erwin, TN by specialty
• Community Health Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.