Provider Demographics
NPI:1316185473
Name:CHENEY, REBECCA JOY (NP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOY
Last Name:CHENEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 710
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37070-0710
Mailing Address - Country:US
Mailing Address - Phone:615-859-1440
Mailing Address - Fax:615-859-0145
Practice Address - Street 1:450 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE C
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-2180
Practice Address - Country:US
Practice Address - Phone:615-859-1440
Practice Address - Fax:615-859-0145
Is Sole Proprietor?:No
Enumeration Date:2009-01-28
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704121427363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner