Healthcare Provider Details

I. General information

NPI: 1639104391
Provider Name (Legal Business Name): CATHY A MACKNET KASNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHY ANNE MACKNET MD

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2358 LIFESTYLE WAY STE 212
CHATTANOOGA TN
37421-4904
US

IV. Provider business mailing address

136 BATTLEFIELD CROSSING CT
RINGGOLD GA
30736-5176
US

V. Phone/Fax

Practice location:
  • Phone: 423-521-1100
  • Fax:
Mailing address:
  • Phone: 706-277-7311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number101393
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number70090
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA89870
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: