Healthcare Provider Details

I. General information

NPI: 1295388841
Provider Name (Legal Business Name): ANN MERCY BINOY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SATHYAVATHY THOMAS PALLIKIZHAKETHIL NURSE PRACTITIONER

II. Dates (important events)

Enumeration Date: 07/23/2019
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 CUMBERLAND ST # 110
CHATTANOOGA TN
37404-1909
US

IV. Provider business mailing address

6891 ROBIN DR
CHATTANOOGA TN
37421-1752
US

V. Phone/Fax

Practice location:
  • Phone: 423-698-0802
  • Fax:
Mailing address:
  • Phone: 678-361-6984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number25702
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: