Individual provider · Type 1 NPI

Tasha Devereaux

Nurse Practitioner · Johnson City, TN

NPI number 1467376905 Active

Practice location

400 N State Of Franklin Rd
Johnson City, TN 37604-6035

Mailing address

717 Poplar St
Elizabethton, TN 37643-2152

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X40488 (TN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1467376905

Tasha Devereaux's National Provider Identifier is 1467376905, issued on Aug 6, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Johnson City, TN. The record was last updated on Aug 6, 2026.