Provider Demographics
NPI:1538275029
Name:LYLE, BRANDEE C (ACNP)
Entity type:Individual
Prefix:
First Name:BRANDEE
Middle Name:C
Last Name:LYLE
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1538
Mailing Address - Country:US
Mailing Address - Phone:615-342-6828
Mailing Address - Fax:615-342-6836
Practice Address - Street 1:2300 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1538
Practice Address - Country:US
Practice Address - Phone:615-342-6828
Practice Address - Fax:615-342-6836
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11523363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4151236OtherBLUE CROSS
TN3644383Medicaid
P00470977OtherRAILROAD MEDICARE
KY7100021060Medicaid
KY7100021060Medicaid