Healthcare Provider Details

I. General information

NPI: 1013970300
Provider Name (Legal Business Name): ARIEL DIANE AVANT RNCNNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 02/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 E 3RD ST BOX 159
CHATTANOOGA TN
37403-2103
US

IV. Provider business mailing address

6410 VININGS LN
OOLTEWAH TN
37363-6422
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-6438
  • Fax: 423-778-8210
Mailing address:
  • Phone: 423-778-6438
  • Fax: 423-778-8210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAPN0000005893
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPN0000005893
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: