Provider Demographics
NPI:1114809373
Name:SHIVERDECKER, MEGAN LEANN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LEANN
Last Name:SHIVERDECKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 471
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37871-0471
Mailing Address - Country:US
Mailing Address - Phone:865-363-0134
Mailing Address - Fax:
Practice Address - Street 1:2706 W HIGHWAY 11E
Practice Address - Street 2:
Practice Address - City:STRAWBERRY PLAINS
Practice Address - State:TN
Practice Address - Zip Code:37871-3432
Practice Address - Country:US
Practice Address - Phone:865-350-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39233363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily