Deette Kay Nicholson, CNM

Primary specialty

MidwifeTaxonomy code 176B00000X

License

APN0000012088 Issued in TN

Practice address

805 Quail Ridge Court
Elizabethton, TN 37643

Phone

(423) 543-1681

Fax

(423) 543-1681

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Miss Deette Kay Junker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437377488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 QUAIL RIDGE COURT",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "37643",
            "telephone_number": "423-543-1681",
            "fax_number": "423-543-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 QUAIL RIDGE COURT",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "37643",
            "telephone_number": "423-543-1681",
            "fax_number": "423-543-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "DEETTE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "TN",
            "license": "APN0000012088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BC BS PROV",
            "identifier": "128CV",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE BC BS PROVIDER",
            "identifier": "3116374",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEETTE",
            "last_name": "JUNKER",
            "middle_name": "KAY",
            "prefix": "MISS",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Midwife in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Midwife in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.