MRS. WANDA FAYE KEAGLE (NPI# 1740565282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740565282 |
| Entity Type | Individual |
| Full Name | MRS. WANDA FAYE KEAGLE |
| Other Name | MRS. WANDA FAYE WILSON |
| Credential | FNP |
| Practice Address |
586 S Jefferson Ave Ste L Cookeville TN 38501-4637 |
| Practice Telephone | 9318540050 |
| Practice Fax Number | 9318540411 |
| Mailing Telephone | 9318540050 |
| Mailing Fax Number | 9318540411 |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2015-03-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
16167 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
586 S JEFFERSON AVE STE L |
| City | COOKEVILLE |
| State | TN |
| Zip Code | 38501-4637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596711 | Results-ast Jv, LLC | Physical Therapist | 627 James Campbell Blvd, South, Suite B, Columbia, TN 38501 | 2020-10-21 |
| 1376167080 | Melinda Jane Jetter | Registered Nurse | 320 North Willow Avenue, Cookeville, TN 38501 | 2020-05-29 |
| 1366950875 | Tara Beth Smith | Occupational Therapist | 315 N Washington Ave Ste 240, Cookeville, TN 38501 | 2018-01-18 |
| 1669990339 | Tonya Rachelle Perry | Counselor | 13 South Jefferson Ave, Cookeville, TN 38501 | 2017-09-01 |
| 1659896207 | Dustin Chase Rich | Physical Therapist | 105 S. Willow Ave, #100, Cookeville, TN 38501 | 2017-08-04 |
| 1487009668 | Holly Young | Physical Therapist | 315 North Washungton Ave., Suite 240, Cookeville, TN 38501 | 2016-04-26 |
| 1194190306 | Johnna Sprague | Nurse Practitioner | 620 S. Jefferson Ave, Suite 202, Cookeville, TN 38501 | 2015-12-14 |
| 1881099885 | Carlos Alberto Podesta | Internal Medicine | 238 W 4th St Ste 200, Cookeville, TN 38501 | 2014-11-03 |
| 1124445002 | Shashank Sarvepalli | Internal Medicine | 1 Medical Center Blvd Ste D, Cookeville, TN 38501 | 2014-03-27 |
| 1689095762 | Kendra Hicks | Licensed Practical Nurse | 701 County Services Drive, Cookeville, TN 38501 | 2013-12-17 |
| Find all providers in zip 38501 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356824379 | Natashia Melton | Nurse Practitioner | 1271 Walton Ln, Cookeville, TN 38501-1866 | 2018-09-14 |
| 1215414628 | Danny Miller | Nurse Practitioner | 606 E Spring St Ste B, Cookeville, TN 38501-5067 | 2018-07-27 |
| 1851893028 | Sarah Delk | Nurse Practitioner | 105 S Willow Ave Ste 100, Cookeville, TN 38501-4668 | 2018-03-05 |
| 1396102521 | British Bates | Nurse Practitioner | 1644 E Spring St, Cookeville, TN 38506-4317 | 2016-01-19 |
| 1194190306 | Johnna Sprague | Nurse Practitioner | 620 S. Jefferson Ave, Suite 202, Cookeville, TN 38501 | 2015-12-14 |
| 1790113553 | Hometown Family Care, LLC | Nurse Practitioner | 675 B South Jefferson Avenue, Cookeville, TN 38501-0950 | 2013-10-14 |
| 1962740217 | Christie Hummel | Nurse Practitioner | 112 N. Walnut Ave, Cookeville, TN 38501 | 2013-01-22 |
| 1922344761 | Grant P Hall | Nurse Practitioner | 1362 Ivy Ln, Cookeville, TN 38501-3057 | 2012-12-26 |
| 1740539063 | Jennifer Lynn Lee | Nurse Practitioner | 4725 Maple Shade Cir, Cookeville, TN 38501-0829 | 2012-08-31 |
| 1780961169 | Heather Harden Cathey | Nurse Practitioner | 1120 Sam's Street, Cookeville, TN 38506 | 2011-11-14 |
| Find all providers in COOKEVILLE | ||||
| City | COOKEVILLE |
| Zip Code | 38501 |
Please comment or provide details below to improve the information on MRS. WANDA FAYE KEAGLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.