Healthcare Provider Details

I. General information

NPI: 1144584467
Provider Name (Legal Business Name): DEANNA APPLE RISHER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 01/11/2024
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 E 10TH ST
COOKEVILLE TN
38501-1807
US

IV. Provider business mailing address

585 E 10TH ST
COOKEVILLE TN
38501-1807
US

V. Phone/Fax

Practice location:
  • Phone: 931-526-6711
  • Fax:
Mailing address:
  • Phone: 931-526-6711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3053
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: