Healthcare Provider Details

I. General information

NPI: 1811015423
Provider Name (Legal Business Name): DEBORAH JOYCE SARDIN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E 3RD ST HAMILTON COUNTY HEALTH DEPARTMENT
CHATTANOOGA TN
37403-2102
US

IV. Provider business mailing address

921 E 3RD ST
CHATTANOOGA TN
37403-2102
US

V. Phone/Fax

Practice location:
  • Phone: 423-209-8262
  • Fax:
Mailing address:
  • Phone: 423-209-8262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN0000078979
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: