Provider Demographics
NPI:1750092714
Name:MUSSLEMAN, DEANNA LYNNE
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:LYNNE
Last Name:MUSSLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HOLLIS CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:IRON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38463-5336
Mailing Address - Country:US
Mailing Address - Phone:931-242-0507
Mailing Address - Fax:
Practice Address - Street 1:726 N LOCUST AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2865
Practice Address - Country:US
Practice Address - Phone:931-766-7056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2022089663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily