Healthcare Provider Details

I. General information

NPI: 1114838356
Provider Name (Legal Business Name): ALLISON NICOLE SHURDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 N JOHNSTON ST STE 305
DALLAS GA
30132-4741
US

IV. Provider business mailing address

800 CHESTNUT ST
CHATTANOOGA TN
37402-2510
US

V. Phone/Fax

Practice location:
  • Phone: 866-598-4571
  • Fax:
Mailing address:
  • Phone: 678-836-4771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: