Healthcare Provider Details

I. General information

NPI: 1154541910
Provider Name (Legal Business Name): KARENG CAVIN GUINN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E 3RD ST
CHATTANOOGA TN
37403-2102
US

IV. Provider business mailing address

1372 GRAYSVILLE RD
RINGGOLD GA
30736-6942
US

V. Phone/Fax

Practice location:
  • Phone: 423-209-8232
  • Fax: 423-209-8241
Mailing address:
  • Phone: 706-937-2740
  • Fax: 423-209-8241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN0000068301
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: