Healthcare Provider Details

I. General information

NPI: 1821167115
Provider Name (Legal Business Name): WOMEN'S INSTITUTE FOR SPECIALIZED HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 GUNBARREL RD SUITE 200
CHATTANOOGA TN
37421-7177
US

IV. Provider business mailing address

1751 GUNBARREL RD SUITE 200
CHATTANOOGA TN
37421-7177
US

V. Phone/Fax

Practice location:
  • Phone: 423-697-1857
  • Fax: 423-697-7564
Mailing address:
  • Phone: 423-697-1857
  • Fax: 423-697-7564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1821167115
License Number StateTN

VIII. Authorized Official

Name: JENNIFER E METCALF
Title or Position: BUS.OFC.MANAGER
Credential:
Phone: 423-697-1857