Provider Demographics
NPI:1588195085
Name:EASON, TREVOR DEAN (NMD, NP-C, DC)
Entity type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:DEAN
Last Name:EASON
Suffix:
Gender:
Credentials:NMD, NP-C, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 N PEACHTREE AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2551
Mailing Address - Country:US
Mailing Address - Phone:269-317-7577
Mailing Address - Fax:
Practice Address - Street 1:336 N PEACHTREE AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2551
Practice Address - Country:US
Practice Address - Phone:931-651-1770
Practice Address - Fax:931-651-1760
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-26
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010557111N00000X
TN0000003219111NN0400X
TN37029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology