Healthcare Provider Details

I. General information

NPI: 1699131524
Provider Name (Legal Business Name): ELLEN MARIE FIKE RHIT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2016
Last Update Date: 01/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 CUMBERLAND ST SUITE 110
CHATTANOOGA TN
37404-1909
US

IV. Provider business mailing address

425 CUMBERLAND ST SUITE 110
CHATTANOOGA TN
37404-1909
US

V. Phone/Fax

Practice location:
  • Phone: 423-495-9117
  • Fax:
Mailing address:
  • Phone: 423-495-9117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number1080895
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: