Healthcare Provider Details

I. General information

NPI: 1215848403
Provider Name (Legal Business Name): DEANNA MICHELE COX FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 BACK VALLEY RD
SPEEDWELL TN
37870-7606
US

IV. Provider business mailing address

540 BACK VALLEY RD
SPEEDWELL TN
37870-7606
US

V. Phone/Fax

Practice location:
  • Phone: 606-670-8217
  • Fax:
Mailing address:
  • Phone: 606-670-8217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number256245
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: