Healthcare Provider Details

I. General information

NPI: 1558652131
Provider Name (Legal Business Name): ASHLEY LYNN HARRIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 PARKWOOD AVE
CHATTANOOGA TN
37404
US

IV. Provider business mailing address

2717 EAST OAKLAND AVENUE
JOHNSON CITY TN
37601-1843
US

V. Phone/Fax

Practice location:
  • Phone: 423-624-1533
  • Fax: 423-803-2222
Mailing address:
  • Phone: 423-926-2358
  • Fax: 423-926-2680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR872285
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP06462
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN001801
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16582
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: