Healthcare Provider Details

I. General information

NPI: 1013825439
Provider Name (Legal Business Name): CHEYENNE L DREW FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W ELK AVE
ELIZABETHTON TN
37643-2654
US

IV. Provider business mailing address

1500 W ELK AVE
ELIZABETHTON TN
37643-2654
US

V. Phone/Fax

Practice location:
  • Phone: 423-929-2584
  • Fax:
Mailing address:
  • Phone: 423-929-2584
  • Fax: 423-722-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number43004
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: