Provider Demographics
NPI:1598212854
Name:DEPRIEST, SHANNON (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:DEPRIEST
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:PUCKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 ROSA HELM WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8408
Mailing Address - Country:US
Mailing Address - Phone:615-354-2460
Mailing Address - Fax:615-746-6095
Practice Address - Street 1:1639 MEDICAL CENTER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2593
Practice Address - Country:US
Practice Address - Phone:615-890-5484
Practice Address - Fax:615-890-7924
Is Sole Proprietor?:No
Enumeration Date:2016-09-04
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily