Provider Demographics
NPI:1093087785
Name:DEASON, MISTY M (CRNA)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:M
Last Name:DEASON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:DAWN
Other - Last Name:MAYFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:76 PEACHTREE ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3505
Mailing Address - Country:US
Mailing Address - Phone:828-274-3477
Mailing Address - Fax:828-274-7407
Practice Address - Street 1:76 PEACHTREE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3505
Practice Address - Country:US
Practice Address - Phone:828-274-3477
Practice Address - Fax:828-574-7407
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17711367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNPI # / SSN#OtherBLUE CROSS
SC478828OtherUNISON
SCAN2177Medicaid
SCNPI # / SSN#OtherBLUE CHOICE
GA003120372AMedicaid
SC30108030OtherFIRST CHOICE - SELECT HEALTH
SCNPI # / SSN#OtherTRICARE
SC478828OtherUNISON
SCAA82831153Medicare PIN