Healthcare Provider Details

I. General information

NPI: 1902737950
Provider Name (Legal Business Name): ALLISON EALEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLI EALEY FNP-C

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 SKYLINE DR
JACKSON TN
38301-3923
US

IV. Provider business mailing address

620 SKYLINE DR
JACKSON TN
38301-3923
US

V. Phone/Fax

Practice location:
  • Phone: 731-541-6280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number235801
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: