Provider Demographics
NPI:1760702484
Name:MASHBURN, DENA LYNN (APN)
Entity Type:Individual
Prefix:MS
First Name:DENA
Middle Name:LYNN
Last Name:MASHBURN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 DAMERON AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-6413
Mailing Address - Country:US
Mailing Address - Phone:865-215-5247
Mailing Address - Fax:865-215-5391
Practice Address - Street 1:140 DAMERON AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-6413
Practice Address - Country:US
Practice Address - Phone:865-215-5000
Practice Address - Fax:865-215-5391
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014753363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily