Healthcare Provider Details

I. General information

NPI: 1003732058
Provider Name (Legal Business Name): JOSIAH DANIELS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 MORRIS HILL RD
CHATTANOOGA TN
37421-2818
US

IV. Provider business mailing address

5133 CHESTNUTT CREEK RD APT 2
APISON TN
37302-2219
US

V. Phone/Fax

Practice location:
  • Phone: 423-499-2300
  • Fax:
Mailing address:
  • Phone: 423-894-4220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10062872
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: