Healthcare Provider Details

I. General information

NPI: 1881409688
Provider Name (Legal Business Name): SHAWN LANCASTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 E CLARK BLVD
MURFREESBORO TN
37130-2121
US

IV. Provider business mailing address

608 E CLARK BLVD
MURFREESBORO TN
37130-2121
US

V. Phone/Fax

Practice location:
  • Phone: 615-893-4618
  • Fax:
Mailing address:
  • Phone: 615-893-4618
  • Fax: 615-893-4656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: JEANINE HEASLEY
Title or Position: INSURANCE AND BILLING
Credential:
Phone: 615-893-4618