Healthcare Provider Details

I. General information

NPI: 1245760347
Provider Name (Legal Business Name): JANELLE SUZANNE CHAIGNE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANELLE SUZANNE EDMONDSON PMHNP-BC

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 VIRGINIA WAY STE 300
BRENTWOOD TN
37027-7611
US

IV. Provider business mailing address

7405 SHALLOWFORD RD STE 230
CHATTANOOGA TN
37421-7632
US

V. Phone/Fax

Practice location:
  • Phone: 615-994-1000
  • Fax: 615-994-0100
Mailing address:
  • Phone: 423-208-8099
  • Fax: 855-305-1008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024187669
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number22974
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number202110418NP-PP
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNUR-APRN-LIC-178407
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: