Healthcare Provider Details

I. General information

NPI: 1013601376
Provider Name (Legal Business Name): HAZUKI CHOE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 MARKET ST #502
CHATTANOOGA TN
37402
US

IV. Provider business mailing address

1230 LYON WAY DRIVE
LAWRENCEVILLE GA
30044
US

V. Phone/Fax

Practice location:
  • Phone: 615-473-8984
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP323884
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: