Healthcare Provider Details

I. General information

NPI: 1659781847
Provider Name (Legal Business Name): S & L HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 BRAINERD RD STE FC5
CHATTANOOGA TN
37411-5310
US

IV. Provider business mailing address

5600 BRAINERD RD STE FC5
CHATTANOOGA TN
37411-5310
US

V. Phone/Fax

Practice location:
  • Phone: 423-355-5471
  • Fax: 423-355-5472
Mailing address:
  • Phone: 423-355-5471
  • Fax: 423-355-5472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberA0706421
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberAPN0000012736
License Number StateTN

VIII. Authorized Official

Name: STEPHANIE SHERIDAN
Title or Position: OWNER
Credential: ANP-C
Phone: 423-355-5471