Healthcare Provider Details

I. General information

NPI: 1891660502
Provider Name (Legal Business Name): TIA ELLISE COLLIER PHARMD, BCCCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 E 3RD ST
CHATTANOOGA TN
37403-2173
US

IV. Provider business mailing address

1357 BALDWIN FIELD CIR
HIXSON TN
37343-5979
US

V. Phone/Fax

Practice location:
  • Phone: 865-386-6801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number41719
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: