MEDICARE: DR. TREVOR DEAN EASON NMD, DNP, NP-C, DC

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	111N00000X	Chiropractor	2301010557	MI
2	111NN0400X	Neurology Chiropractor	0000003219	TN
3	363LF0000X	Family Nurse Practitioner	37029	TN

General Provider Information

NPI Number	:	1588195085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TREVOR DEAN EASON NMD, DNP, NP-C, DC

Provider Business Mailing Address
First Line	:	336 N PEACHTREE AVE
Second Line	:
City	:	COOKEVILLE
State	:	TN
Zip	:	38501-2551
Country	:	US
Telephone Number	:	269-317-7577
Fax Number	:

Provider Business Practice Location Address
First Line	:	336 N PEACHTREE AVE
Second Line	:
City	:	COOKEVILLE
State	:	TN
Zip	:	38501-2551
Country	:	US
Telephone Number	:	931-651-1770
Fax Number	:	931-651-1760

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

Provider Enumeration Date	:	03/26/2017
Last Update Date	:	12/06/2025

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