Individual ProviderDeena CantrillNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1915 White Ave, Knoxville, TN 37916(865) 331-1720PECOS EnrollmentBased on the most recent information from CMS, provider Deena Cantrill is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1194175083Provider TypeIndividualFull NameCantrill, DeenaGenderFemaleSole ProprietorNoEnumeration Date6/21/2016Last Updated8/25/2020Contact InformationPractice LocationPractice Address1915 White Ave, Knoxville, TN 37916Phone(865) 331-1720FaxUnlisted FaxMailing LocationMailing Address1915 White Ave, Knoxville, TN 37916-2300Phone(865) 331-1720FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense21365TennesseeCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense178375TennesseeProvider IdentifiersIDDescriptionIssuerIDQ028950DescriptionMedicaidIssuerUnlistedTennessee