Healthcare Provider Details

I. General information

NPI: 1699325316
Provider Name (Legal Business Name): DAVIDA YVONNE ASBURY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2019
Last Update Date: 11/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 COOK DR
ATHENS TN
37303-3485
US

IV. Provider business mailing address

519N MEADOWVIEW LN
DECATUR TN
37322-7719
US

V. Phone/Fax

Practice location:
  • Phone: 423-745-3394
  • Fax:
Mailing address:
  • Phone: 423-596-6190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number0000150419
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000026644
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: