Healthcare Provider Details

I. General information

NPI: 1811977499
Provider Name (Legal Business Name): SHELIA G HANNER MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CUMBERLAND ST
CHATTANOOGA TN
37404-1922
US

IV. Provider business mailing address

6049 SHALLOWFORD ROAD
CHATTANOOGA TN
37421-1688
US

V. Phone/Fax

Practice location:
  • Phone: 423-266-6751
  • Fax: 423-763-4650
Mailing address:
  • Phone: 423-266-6751
  • Fax: 423-763-4650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN6546
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN0000087880
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: