Healthcare Provider Details

I. General information

NPI: 1851651731
Provider Name (Legal Business Name): SARAH KATHLEEN HAFNER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH KATHLEEN GREGG

II. Dates (important events)

Enumeration Date: 05/24/2012
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 SPRING CREEK RD
CHATTANOOGA TN
37412-3909
US

IV. Provider business mailing address

941 SPRING CREEK RD
CHATTANOOGA TN
37412-3909
US

V. Phone/Fax

Practice location:
  • Phone: 423-894-7870
  • Fax:
Mailing address:
  • Phone: 423-894-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16685
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: