Healthcare Provider Details

I. General information

NPI: 1124674403
Provider Name (Legal Business Name): HAYLEY BREWSTER RUEBUSCH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6734 LEE HWY
CHATTANOOGA TN
37421-2423
US

IV. Provider business mailing address

6734 LEE HWY
CHATTANOOGA TN
37421-2423
US

V. Phone/Fax

Practice location:
  • Phone: 423-899-0431
  • Fax:
Mailing address:
  • Phone: 423-899-0431
  • Fax: 423-499-9552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26300
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: