Provider Demographics
NPI:1275683252
Name:PRESLEY, CHAUNDEL L (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHAUNDEL
Middle Name:L
Last Name:PRESLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 HIGHWAY 52 BYP W
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083-1728
Mailing Address - Country:US
Mailing Address - Phone:615-688-2273
Mailing Address - Fax:615-688-2271
Practice Address - Street 1:10427 NEW HWY 52 WEST
Practice Address - Street 2:
Practice Address - City:WESTMORELAND
Practice Address - State:TN
Practice Address - Zip Code:37186
Practice Address - Country:US
Practice Address - Phone:615-644-2000
Practice Address - Fax:615-644-2078
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6659363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN337255Medicaid
S15834Medicare UPIN
TN3342793Medicare PIN
TN3342793Medicare ID - Type Unspecified