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NPI Code Detail

MEDICARE: MRS. CATHERINE CRAWFORD HUSTAD FNP-C

MEDICARE: MRS. CATHERINE CRAWFORD HUSTAD FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPN0000021163TN

General Provider Information

NPI Number : 1588114623
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHERINE CRAWFORD HUSTAD FNP-C
Provider Business Mailing Address
First Line : 1067 RIVERFRONT PKWY STE 201
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37402-2222
Country : US
Telephone Number : 423-822-5709
Fax Number : 855-930-4125
Provider Business Practice Location Address
First Line : 3074 HICKORY VALLEY RD BLDG 229
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-1273
Country : US
Telephone Number : 423-558-3111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2016
Last Update Date : 02/23/2022

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