Healthcare Provider Details

I. General information

NPI: 1952889602
Provider Name (Legal Business Name): ASHLEY STILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2018
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 E 3RD ST
CHATTANOOGA TN
37403-2147
US

IV. Provider business mailing address

PO BOX 308
BENTON TN
37307-0308
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-7000
  • Fax:
Mailing address:
  • Phone: 423-338-8995
  • Fax: 423-338-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number24516
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: