Healthcare Provider Details

I. General information

NPI: 1811547201
Provider Name (Legal Business Name): MARTHA KATHERINE RUMBLE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTHA KATHERINE SCROGGINS

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6031 SHALLOWFORD RD STE 113
CHATTANOOGA TN
37421-1984
US

IV. Provider business mailing address

9136 CARISSA DR
BRENTWOOD TN
37027-8848
US

V. Phone/Fax

Practice location:
  • Phone: 423-825-8500
  • Fax:
Mailing address:
  • Phone: 256-794-2477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-159517
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number241318
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26695
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: