Healthcare Provider Details

I. General information

NPI: 1477573970
Provider Name (Legal Business Name): ANGELA C. MEJIAS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E 37TH ST
CHATTANOOGA TN
37410-1401
US

IV. Provider business mailing address

PO BOX 11263
CHATTANOOGA TN
37401-2263
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-2700
  • Fax: 423-778-2709
Mailing address:
  • Phone: 423-778-3274
  • Fax: 423-778-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8373
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: