Provider Demographics
NPI:1831676840
Name:DEASON, AMANDA (NP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:DEASON
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 1:451 HIGHWAY 13 S
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:TN
Mailing Address - Zip Code:37185-2109
Mailing Address - Country:US
Mailing Address - Phone:931-296-0211
Mailing Address - Fax:
Practice Address - Street 1:451 HIGHWAY 13 S
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:TN
Practice Address - Zip Code:37185-2109
Practice Address - Country:US
Practice Address - Phone:931-296-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily