Healthcare Provider Details

I. General information

NPI: 1407776412
Provider Name (Legal Business Name): MIEKE BAISLEY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3317 DAYTON BLVD UNIT 15781
CHATTANOOGA TN
37415-4764
US

IV. Provider business mailing address

421 GLENHILL CIR
RED BANK TN
37415-4909
US

V. Phone/Fax

Practice location:
  • Phone: 423-827-5300
  • Fax:
Mailing address:
  • Phone: 574-217-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16791
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: