Healthcare Provider Details

I. General information

NPI: 1033618228
Provider Name (Legal Business Name): HANNAH CHONG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 DORCHESTER RD STE 117
CHATTANOOGA TN
37405-4432
US

IV. Provider business mailing address

1301 DORCHESTER RD STE 117
CHATTANOOGA TN
37405-4432
US

V. Phone/Fax

Practice location:
  • Phone: 423-267-5060
  • Fax:
Mailing address:
  • Phone: 423-267-5060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23441
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: