Healthcare Provider Details

I. General information

NPI: 1730468042
Provider Name (Legal Business Name): JOSHUA C. ZARZOUR CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2011
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 E. THIRD STREET
CHATTANOOGA TN
37403-2147
US

IV. Provider business mailing address

PO BOX 11225
CHATTANOOGA TN
37401-2225
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-7608
  • Fax: 423-778-2360
Mailing address:
  • Phone: 423-892-5602
  • Fax: 423-892-5838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN153449
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN15984
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: