Healthcare Provider Details

I. General information

NPI: 1043450620
Provider Name (Legal Business Name): CHRISTY DAWN TITTSWORTH APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 MACKEY BRANCH DR
CHATTANOOGA TN
37421-3225
US

IV. Provider business mailing address

1360 MACKEY BRANCH DR
CHATTANOOGA TN
37421-3225
US

V. Phone/Fax

Practice location:
  • Phone: 423-443-3336
  • Fax: 423-464-7510
Mailing address:
  • Phone: 423-443-3336
  • Fax: 423-464-7510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11033
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number11033
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11033
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: