Healthcare Provider Details

I. General information

NPI: 1932052248
Provider Name (Legal Business Name): EMILY MAKAYLA DUNAWAY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 OLD HICKORY BLVD STE G
JACKSON TN
38305-2911
US

IV. Provider business mailing address

505 PINE LAKE RD
LEXINGTON TN
38351-7563
US

V. Phone/Fax

Practice location:
  • Phone: 731-664-6610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number40994
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: