Healthcare Provider Details

I. General information

NPI: 1134679038
Provider Name (Legal Business Name): COURTNEY RENEE HARRIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 SHALLOWFORD RD
CHATTANOOGA TN
37421-5406
US

IV. Provider business mailing address

6401 SHALLOWFORD RD
CHATTANOOGA TN
37421-5406
US

V. Phone/Fax

Practice location:
  • Phone: 423-339-9581
  • Fax: 423-472-0454
Mailing address:
  • Phone: 423-893-6500
  • Fax: 629-224-5044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN21965
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: