Healthcare Provider Details

I. General information

NPI: 1780567339
Provider Name (Legal Business Name): JULIA HARNESS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 DESALES AVE
CHATTANOOGA TN
37404-1161
US

IV. Provider business mailing address

168 MAPLETON RIDGE DR NW
CLEVELAND TN
37312-6010
US

V. Phone/Fax

Practice location:
  • Phone: 423-495-2525
  • Fax:
Mailing address:
  • Phone: 423-716-3815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number39765
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number230944
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: