Healthcare Provider Details

I. General information

NPI: 1013822014
Provider Name (Legal Business Name): MS. DANIELLE LEE BUNN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3803 DAYTON BLVD
CHATTANOOGA TN
37415-4010
US

IV. Provider business mailing address

3803 DAYTON BLVD
CHATTANOOGA TN
37415-4010
US

V. Phone/Fax

Practice location:
  • Phone: 619-666-2866
  • Fax:
Mailing address:
  • Phone: 619-666-2866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number210
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: