MEDICARE: EDITH DEAN FNP

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	17400	TN

General Provider Information

NPI Number	:	1609218726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDITH DEAN FNP

Provider Business Mailing Address
First Line	:	353 NEW SHACKLE ISLAND RD STE 148C
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-2366
Country	:	US
Telephone Number	:	615-972-1100
Fax Number	:	615-537-4950

Provider Business Practice Location Address
First Line	:	353 NEW SHACKLE ISLAND RD STE 148C
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-2366
Country	:	US
Telephone Number	:	615-972-1100
Fax Number	:	615-537-4950

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

Provider Enumeration Date	:	07/18/2013
Last Update Date	:	02/17/2026

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Directions to “ EDITH DEAN FNP” Practice Location

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