Healthcare Provider Details

I. General information

NPI: 1982988325
Provider Name (Legal Business Name): KAREN ELIZABETH HULLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 E 3RD ST SUITE 100
CHATTANOOGA TN
37404-2600
US

IV. Provider business mailing address

979 E 3RD ST SUITE 300
CHATTANOOGA TN
37403-2136
US

V. Phone/Fax

Practice location:
  • Phone: 423-267-0466
  • Fax: 423-757-0770
Mailing address:
  • Phone: 423-267-0466
  • Fax: 423-757-0770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN16030
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: