MEDICARE: MR. DAVID WARREN YANCEY APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APN 6666	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4118867	OTHER	TN	BLUE CROSS BLUE SHIELD PIN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447237649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID WARREN YANCEY APRN

Provider Business Mailing Address
First Line	:	10161 US HWY 70 EAST
Second Line	:
City	:	MC EWEN
State	:	TN
Zip	:	37101-4442
Country	:	US
Telephone Number	:	931-582-3170
Fax Number	:	931-582-3178

Provider Business Practice Location Address
First Line	:	10161 US HWY 70 EAST
Second Line	:
City	:	MCEWEN
State	:	TN
Zip	:	37101
Country	:	US
Telephone Number	:	931-582-3170
Fax Number	:	931-582-3178

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	03/07/2019

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