Healthcare Provider Details

I. General information

NPI: 1396649646
Provider Name (Legal Business Name): MIYANNI-MYKEI YANEISHA NELSON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LEBANON RD
MURFREESBORO TN
37129-1392
US

IV. Provider business mailing address

3411 QUINTANA DR
MURFREESBORO TN
37127-9827
US

V. Phone/Fax

Practice location:
  • Phone: 615-867-6000
  • Fax:
Mailing address:
  • Phone: 616-437-8529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number43101
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: