Basic Information
| Provider Information | |||||||||
| NPI: | 1316185473 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHENEY | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | JOY | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 710 | ||||||||
| Address2: | |||||||||
| City: | GOODLETTSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370700710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158591440 | ||||||||
| FaxNumber: | 6158590145 | ||||||||
| Practice Location | |||||||||
| Address1: | 450 PROFESSIONAL PARK DR | ||||||||
| Address2: | SUITE C | ||||||||
| City: | GOODLETTSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370722180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158591440 | ||||||||
| FaxNumber: | 6158590145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2009 | ||||||||
| LastUpdateDate: | 02/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 4704121427 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.