Provider Demographics
NPI:1447237649
Name:YANCEY, DAVID WARREN (APRN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WARREN
Last Name:YANCEY
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10161 US HWY 70 EAST
Mailing Address - Street 2:
Mailing Address - City:MC EWEN
Mailing Address - State:TN
Mailing Address - Zip Code:37101-4442
Mailing Address - Country:US
Mailing Address - Phone:931-582-3170
Mailing Address - Fax:931-582-3178
Practice Address - Street 1:10161 US HWY 70 EAST
Practice Address - Street 2:
Practice Address - City:MCEWEN
Practice Address - State:TN
Practice Address - Zip Code:37101
Practice Address - Country:US
Practice Address - Phone:931-582-3170
Practice Address - Fax:931-582-3178
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 6666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4118867OtherBLUE CROSS BLUE SHIELD PIN
TN3344296Medicaid
TN3344296Medicare PIN
S42939Medicare UPIN