Provider Demographics
NPI:1447880034
Name:CODY, MEGAN EVERETT (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:EVERETT
Last Name:CODY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:RECHELLE
Other - Last Name:EVERETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 COATSLAND DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3908
Mailing Address - Country:US
Mailing Address - Phone:731-541-8854
Mailing Address - Fax:
Practice Address - Street 1:300 COATSLAND DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3908
Practice Address - Country:US
Practice Address - Phone:731-541-8854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily