Provider Demographics
NPI:1679630891
Name:SPEIGHT, DEANNA K (DNP, APRN-BC, FNP)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:K
Last Name:SPEIGHT
Suffix:
Gender:F
Credentials:DNP, APRN-BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 TABB DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:MUNFORD
Mailing Address - State:TN
Mailing Address - Zip Code:38058-8611
Mailing Address - Country:US
Mailing Address - Phone:901-840-2102
Mailing Address - Fax:901-840-1979
Practice Address - Street 1:76 TABB DR
Practice Address - Street 2:SUITE E
Practice Address - City:MUNFORD
Practice Address - State:TN
Practice Address - Zip Code:38058-8611
Practice Address - Country:US
Practice Address - Phone:901-840-2102
Practice Address - Fax:901-840-1979
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6874363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509249Medicaid
TNQ01186Medicare UPIN