Basic Information
Provider Information
NPI: 1659035434
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GODSEY
FirstName: KRISTIN
MiddleName: LLEWELLYN
NamePrefix: MRS.
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LLEWELLYN
OtherFirstName: KRISTIN
OtherMiddleName: ANNETTE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3841 GREEN HILLS VILLAGE DR STE 200
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372152691
CountryCode: US
TelephoneNumber: 6159362000
FaxNumber:  
Practice Location
Address1: 3601 THE VANDERBILT CLINIC
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372321333
CountryCode: US
TelephoneNumber: 6159369177
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/27/2021
LastUpdateDate: 03/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X30742TNY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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